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Issue 1092 coverWomen's Health and Disease: Gynecologic, Endocrine, and Reproductive Issues Volume 1092 published December 2006
Ann. N.Y. Acad. Sci. 1092: 418–425 (2006). doi: 10.1196/annals.1365.040
Copyright © 2006 by the New York Academy of Sciences
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Part X. Selected Research Papers

Poor Responders in IVF

Cancellation of a First Cycle Is Not Predictive of a Subsequent Failure

STAVROULA BAKAa, EVANGELOS MAKRAKISa, DESPOINA TZANAKAKIa, SOCRATES KONIDARISa, DIMITRIS HASSIAKOSa, THEODOROS MOUSTAKARIASa AND GEORGE CREATSASa

a IVF Unit, Second Department of Obstetrics and Gynecology, Aretaieion Hospital, University of Athens, Athens, Greece

Key Words: poor responders • IVF • ovarian stimulation • pregnancy rate

Address for correspondence: Stavroula Baka, M.D., IVF Unit, Second Department of Obstetrics and Gynecology, Aretaieion Hospital, University of Athens, 76 Vas. Sofias Ave., GR-11528 Athens, Greece. Voice: +30-210-6517467; fax: +30-210-7233330.  e-mail: ivf{at}aretaieio.uoa.gr

Management of women with a poor response to controlled ovarian hyperstimulation during IVF remains a frustrating challenge. The present study included 96 cycles from an equal number of women with a poor ovarian response and successful oocyte retrieval. Poor response was defined by the presence of at least one of the following characteristics: three or fewer oocytes on retrieval, serum estradiol level less than 500 pg/mL on the day of hCG administration, and serum FSH levels less than 20 IU/L. The same patients had a previous cycle cancelled because of a poor ovarian response whereas in the second cycle they preferred to continue the treatment despite the poor prognosis. We obtained 241 oocytes in the 96 IVF cycles. The fertilization rate was 60.2%. Three oocytes per cycle were retrieved in 56 cycles (58.3%), two oocytes per cycle in 33 cycles (34.4%), and one oocyte per cycle in 7 cycles (7.3%). In 19 cycles (19.8%) no fertilization was achieved. An embryo transfer was finally performed in 74 out of 96 cycles. Pregnancy rate was 12.5% per cycle and 16.2% per transfer. Among the 12 pregnancies achieved, 7 were in the 3-oocyte cycles and 5 in the 2-oocyte cycles. No pregnancies were achieved in the 1-oocyte cycles. Our data demonstrate that continuation of therapy in poor responders undergoing IVF can be an option despite the low pregnancy rates. The prognosis of these patients is not affected by a poor response in the first cycle and for some of them the outcome can be favorable.




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