Defining poor ovarian response during IVF cycles, in women aged &lt;40 years, and its relationship with treatment outcome

Kailasam, C.; Keay, Stephen D.; Wilson, Philip; Ford, W. C. L.; Jenkins, Julian

doi:10.1093/humrep/deh273

Cited by 91 publications

(26 citation statements)

References 31 publications

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“…16 Exogenous FSH is administrated to women undergoing IVF and variable ovarian responses have been reported, ranging from high response to the minimal dose of FSH which causes ovarian hyper stimulation syndrome (OHSS), to poor response even with higher doses of FSH which leads to low retrieved mature oocytes. 17 The poor responders may need to repeat stimulation cycles with higher financial burden. According to the present results which indicated that SNP of the core promoter region at position -29 of the FSHR gene may influence sensitivity of the FSHR to FSH in vivo, it may be suggested that women with A/A genotype at position -29 will show poor ovarian response, and so will require higher doses of exogenous FSH for ovulation induction during IVF process.…”

Section: Discussionmentioning

confidence: 99%

Association of FSH receptor promoter’s polymorphisms with IVF-failure in Iranian women

Bonyadi

Damavandi

Chibine

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: Follicle-Stimulating Hormone Receptor (FSHR) gene shows five Single Nucleotide Polymorphisms (SNPs) in the promoter region at positions -29, -37, - 114, -123 and -138 that have been reported to be associated with higher levels of FSH and various ovarian responses to FSH in IVF (In-vitro fertilization) treatment at different populations. Hence, they are important regulators of hormone activity at the target level in IVF process. This study was performed to investigate the association between FSHR gene polymorphisms and IVF failure in Iranian women.Methods: SNPs in the promoter region of FSHR gene were analyzed by PCR and direct sequencing technique in 90 women in three equally sized groups of IVF failure, IVF success and normal fertile women, using genomic DNA extracted from white blood cells.Results: No significant differences were found in allelic variants frequency and genotype distribution between each category of subjects when analyzing the FSHR SNPs in the promoter region (p-value >0.05). However, analysis of the data revealed that the subjects with A/A genotype at the –29 position received higher amount of exogenous FSH for ovulation induction compared to G/G genotypes.Conclusions: These results indicate that the FSHR SNP at position –29 may influence sensitivity of the FSHR to FSH for ovulation induction in IVF treatment. It may be concluded that the A/A genotype at position –29 is associated with poor ovarian response to FSH so that subjects with A/A genotype at the –29 position may require higher doses of exogenous FSH for ovulation induction during IVF process.

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Section: Discussionmentioning

confidence: 99%

Association of FSH receptor promoter’s polymorphisms with IVF-failure in Iranian women

Bonyadi

Damavandi

Chibine

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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“…The cut-off levels for the number of follicles or oocytes that define poor response vary widely from study to study. Some authors feel that the definition of poor response should also include the degree of ovarian stimulation used and that a low oocyte number is detrimental only when high total dose of follicle stimulating hormone (FSH) has been administered [139]. Various endocrine and ultrasonographic markers and dynamic tests to assess ovarian reserve have been evaluated.…”

Section: Poor Ovarian Responsementioning

confidence: 99%

Intracytoplasmic Sperm Injection – Factors Affecting Fertilization

Javed¹,

Michael²

2012

Enhancing Success of Assisted Reproduction

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“…In addition to a quantitative reduction of their oocyte cohorts, poor ovarian responder patients (PORs) present a high risk of implantation failure that may suggest a compromised oocyte quality [2]. …”

Section: Introductionmentioning

confidence: 99%

Myo-inositol therapy for poor-responders during IVF: a prospective controlled observational trial

Caprio¹,

D’Eufemia²,

Trotta³

et al. 2015

J Ovarian Res

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BackgroundThe overall incidence of poor ovarian response in IVF cycles has been reported to be between 9 and 24 %. The management of these patients remains a significant challenge in assisted reproduction. The aim of the present study was to evaluate the effect of myo-inositol (MI) on ovarian function in poor responders undergoing ICSI.MethodsThe study is a prospective controlled observational trial, that involved 72 poor responders included in an ICSI program and divided into two groups; group A: 38 patients who have been assuming MI (4 g) + folic acid (FA) (400 μg) for the previous 3 months before the enrollment day; group B: 38 patients assuming FA (400 μg) alone for the same period. COH was carried out in the same manner in the two groups. The main goal was the assessment of oocytes retrieved number and quality; secondary endpoints were the Ovarian Sensitivity Index (OSI: n° oocytes retrieved/total Gonadotropins units × 1000), oestradiol levels on the day of hGC, fertilization rate, implantation rate, ongoing pregnancy rate.ResultsThere was no significant difference between the two groups regarding oestradiol level, but total rec-FSH units were significantly lower (p = 0.004) and M2 oocytes rate significantly higer (p = 0.01) in group A. The ovarian sensitivity index was higher, reaching a statistical significance (p < 0.05), in the group of patients pre-treated with MI, showing an improvement in ovarian sensibility to gonadotropin.ConclusionsOur results suggest that MI therapy in poor responders results in an increased of the number of oocytes recovered in MII and of the gonadotropin Ovarian Sensitivity Index (OSI), suggesting a MI role in improving ovarian response to gonadotropins. Therefore MI seems to be helpful in “poor responders” undergoing IVF cycles.

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Defining poor ovarian response during IVF cycles, in women aged <40 years, and its relationship with treatment outcome

Abstract: Definitions of poor response should include the degree of ovarian stimulation used. A low oocyte number is only detrimental if the cumulative dose is >3000 IU FSH. Cancellation at >/=300 IU FSH/day is associated with a significantly worse prognosis and could define poor response.

Cited by 91 publications

References 31 publications

Association of FSH receptor promoter’s polymorphisms with IVF-failure in Iranian women

Association of FSH receptor promoter’s polymorphisms with IVF-failure in Iranian women

Intracytoplasmic Sperm Injection – Factors Affecting Fertilization

Myo-inositol therapy for poor-responders during IVF: a prospective controlled observational trial

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