Hum. Reprod. Advance Access originally published online on May 13, 2004
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Human Reproduction, Vol. 19, No. 7, 1544-1547,
July 2004
© 2004 European Society of Human Reproduction and Embryology
Defining poor ovarian response during IVF cycles, in women aged <40 years, and its relationship with treatment outcome
1 Centre for Reproductive Medicine, Division of Obstetrics and Gynaecology, University of Bristol, St Michael’s Hospital, Southwell St, Bristol, BS2 8EG and 2 Department of Biological Sciences, University of Warwick, Gibbet Hill Road, Coventry CV4 7AL, UK
3 To whom correspondence should be addressed. e-mail: Chandra.Kailasam{at}repromed-bristol.co.uk
BACKGROUND: Poor ovarian response limits IVF success but assessing interventions is difficult because of the wide variation in definition. This study attempts to derive objective definitions of poor response. METHODS: A retrospective study of a consecutive series of 1190 patients aged <40 years undergoing their first IVF/ICSI cycle was undertaken. Factors adversely affecting implantation, including advanced female age, were excluded. Clinical outcome in cycles reaching oocyte retrieval (n = 1036) were evaluated with respect to gonadotrophin dose used and oocyte number. Cancelled cycles (n = 154) were analysed in relation to the stimulation dose at cancellation and outcome of their subsequent cycle. RESULTS: Cycle cancellation for patients on 
300 IU FSH/day compared to those on a lower dose was associated with a significantly worse outcome in the subsequent cycle. If <3000 IU FSH/cycle were administered, clinical pregnancy rates remained favourable if <4 eggs were recovered (29 versus 33% for 5 eggs). By contrast, if 3000 IU FSH was required, the pregnancy rate was 25% if 5 eggs were recovered but declined to 7% if <4 were obtained. CONCLUSIONS: 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.
Key words: definition/gonadotrophins/IVF/poor ovarian response
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C. Kailasam, S.D. Keay, P. Wilson, W.C. Ford, and J.M. Jenkins Reply to 'Defining poor ovarian response during IVF cycles, in women aged <40 years, and its relationship with treatment outcome' Hum. Reprod., February 1, 2005; 20(2): 573 - 574. [Full Text] [PDF]
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