Xu B, et al. - A 15-year population-based observational cohort study was conducted to determine the cumulative live birth rates (CLBRs) in women with poor ovarian response (POR) diagnosed according to the Bologna criteria. It was noted that the CLBR declined with increasing age for women with POR. As compared to young poor responders (<35 years), women with advanced age (≥38 years) achieved a significantly lower CLBR. Researchers reported that very low CLBR was correlated with women aged >43 years old and natural cycle IVF was of no advantage for these patients.

Methods

• A 15-year population-based observational cohort study was conducted at teaching hospital.
• An aggregate of 3,391 women with POR were followed from their first fresh, nondonor IVF cycle until they had a live birth or discontinued treatment between 2002 and 2016.
• All IVF and intracytoplasmic sperm injection (ICSI) cycles and cryocycles were involved in this analysis.
• Live birth rates per initiated cycle, the conservative and optimistic CLBR for multiple IVF cycles were the main outcomes measures.

Results

• According to the findings obtained, the CLBRs after six IVF cycles were 14.9% for the conservative and 35.3% for the optimistic estimate.
• It was observed that the CLBR reduced from 22% for women ≤30 years to 18.3% for women aged 31–34 years, 17.2% for 35–37 years, 13.5% for 38–40 years, 10.5% for 41–43 years, and 4.4% among women >43 years in the conservative analysis.
• The data presented in this work showed a significant decreased CLBR starting at age 38 years compared with women <35 years.
• Findings revealed that after adjusting for age, antral follicle count, basal FSH level, and IVF cycle number, natural cycles were related to the lowest CLBR among all the protocols, and this difference was significant compared with the other protocols.