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Analysis of factors associated with ovarian reserve in a group of poor responders to in vitro fertilization: A cross-sectional study
Wiweko, Budi; Afdi, Quamila Fahrizani; Harzif, Achmad Kemal; Pratama, Gita; Sumapradja, Kanadi; Muharam, Raden; Hestiantoro, Andon & Zakirah, Sarah Chairani
Abstract
Background: Poor ovarian reserve and a high rate of pregnancy failure associated
with low quality and quantity of oocytes are observed in poor responders to in vitro
fertilization.
Objective: To assess the effect of age, body mass index (BMI), endometriosis, and
history of ovarian surgery on ovarian reserve in a group of poor responders.
Materials and Methods: In this cross-sectional study 749 women who referred to
Yasmin Clinic of Dr. Cipto Mangunkusumo National General Hospital from January
2013 to June 2017 were enrolled. Two definitions of poor responders and Poseidon
criteria and consecutive sampling techniques were used. Participants were divided
into good and poor responder groups based on the ovarian reserve test; participant
with oocyte ≤ 3 was classified as a poor responder. Based on this, 188 participants with
nine (4-47) oocytes were included in the poor responder group. While, good responder
comprised of two (0-3) oocytes.
Results: Age and anti-Mullerian hormone level (AMH) were significantly associated
with ovarian reserve in the poor-responder group (p < 0.001). However, in multivariate
analyses, age was the only significant predictor of ovarian response in the poor-responder
group (p = 0.004). While endometriosis was the significant predictor of
Poseidon groups 1 and 4, surgical history was the significant predictor of Poseidon
groups 2 and 3. Meanwhile, an increase in BMI decreased the risk of classification
under Poseidon group 3.
Conclusion: Age, AMH, BMI, endometriosis, and history of ovarian surgery affected the
risk of classification of the Poseidon group.
Keywords
Ovarian reserve; Poseidon; In vitro fertilization.
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