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IntroductionThis study aims to compare the association between the most commonly used ovarian responsiveness markers – age, anti-Müllerian hormone levels (AMH), antral follicle count (AFC), ovarian sensitivity index (OSI), and ovarian response prediction index (ORPI) – and ovarian responsiveness to gonadotropin stimulation in assisted reproductive technology (ART) cycles.Material and methodsPatients who underwent intracytoplasmic sperm injection treatment using either a gonadotropin releasing hormone (GnRH) antagonist or agonist protocol were enrolled in the study. Data of the patients were abstracted from the hospital’s database. Tests were compared for total number of retrieved oocytes, metaphase II (MII) oocytes, embryos, good quality embryos on day 1 and day 3, and ongoing pregnancies per cycle.ResultsThe OSI was the ovarian response test that had the strongest relationship with the ART outcomes. The level of association between the ovarian response tests and poor ovarian response data was (in descending order): OSI, ORPI, AFC, AMH, and age (AUCOSI = 0.976, AUCORPI = 0.905, AUCAFC = 0.899, AUCAMH = 0.864, AUCage = 0.617). The overall association between OSI and poor ovarian response was significantly higher than the other parameters (p 1 = 0.0023, p 2 = 0.0014, p 3 = 0.0001, p 4 ≤ 0.0001). In patients with high ovarian response data, OSI had the highest association, followed by AFC and ORPI age (AUCOSI = 0.984, AUCAFC = 0.907, AUCORPI = 0.887). There was no statistically significant difference among the tests for the data of patients with ongoing pregnancies.ConclusionsIn this study, which is the first study comparing the five most frequently used ovarian responsiveness markers and the second study signifying the role of OSI in an antagonist protocol, OSI was found to be more convenient to calculate, and it could be superior to other ovarian responsiveness markers for poor and high ovarian responses on cycles with agonist or antagonist protocols.

Objective: To compare embryo transfer (ET) technique based on catheter rotation during its withdrawal in cases with unexplained infertility in a prospective, randomized trial (NCT03097042). Methods: Two hundred intracytoplasmic sperm injection (ICSI) patients undergoing ET with cleaving or blastocyst-stage fresh embryos were randomized into 2 groups: cases with (n = 100), and without (n = 100) catheter rotation during its withdrawal. Groups were matched for age and some clinical parameters. A soft catheter was used to transfer a single embryo with catheter rotation during its withdrawal in the study group and without rotation in the control. The use of a stiff catheter or tenaculum was not needed in any case. Groups were compared in terms of cycle characteristics and clinical pregnancy rates. Results: Pregnancy rate was significantly higher in the study group (41 vs. 26%, p = 0.04). Clinical pregnancy rate was also significantly higher in the study group (39 vs. 25%, OR 1.9 [1.1–3.5], p = 0.05). On the other hand, the ongoing pregnancy rate was similar between the 2 groups (33 vs. 23%, p = 0.2). Conclusion: Catheter rotation during its withdrawal may be associated with increased pregnancy and clinical pregnancy rates; however, the difference in ongoing pregnancy rates did not reach statistical significance.

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Our data show that oocyte cytoplasmic abnormalities significantly reduce fertilization achievement in poor responders.