Subfertile Chinese patients with diminished ovarian reserve: An analysis of pregnancy outcomes of ART cycles

  • Zeng-Yan Wang Center for Reproductive Medicine, First Affiliated Hospital of Sun Yat-sen University
  • Shu-Xing Huang Department of Oral and Maxillofacial Surgery, First Affiliated Hospital of Sun Yat-sen University
  • Jing-Di Yang Center for Reproductive Medicine, First Affiliated Hospital of Sun Yat-sen University
  • Dan-Ping Li
  • Yan-Wen Xu
Keywords: Reproductive Techniques, Assisted, Insemination, Artificial, Infertility, Pregnancy Outcome, In vitro fertilization, Diminished Ovarian Reserve

Abstract

Objective: To analyze the pregnancy outcomes of patients presenting with infertility solely due to diminished ovarian reserve (DOR) and treated by assisted reproductive technology (ART), including artificial insemination by husband (AIH) and in vitro fertilization (IVF).

Methods: This was a retrospective study of subfertile patients due to DOR attending the Center for Reproductive Medicine in Guangzhou, China, between January 2010 and October 2015. Patients were assigned into either the AIH or IVF group. Within each group, these patients were further subgrouped based on their serum basal follicle-stimulating hormone (bFSH) level (10 ≤ bFSH ≤ 12IU/L and bFSH > 12IU/L) and age (20–30, 31–35, 36–40, and 41–45 years). The live birth rates were compared among these groups and subgroups.

Results: A total of 1,003 patients with a median age of 38.91 (21–45) years were enrolled in the study. The live birth rate following AIH was 5.61% (25/446), which was significantly lower than that following IVF (25.13%; 140/557). In the subgroup analysis, the cumulative live birth rates in AIH group were significantly lower than those in the IVF groups (in the 10–12 IU/L bFSH subgroup, 13.74% vs. 41.13% (P<0.05) for patients aged ≤35 years, and 4.82% vs. 19.77% (P<0.05) for patients aged >35 years; in the >12 IU/L bFSH subgroup, 9.52% vs. 29.91% (P<0.05) for patients aged ≤35 years, and 5.71% vs. 20.55% (P<0.05) for patients aged >35 years). Longitudinal analysis showed that majority of live births, in AIH or IVF groups, were achieved in the first two cycles.

Conclusions: In subfertile women with DOR, live birth rates following AIH were significantly lower than IVF, especially for the aged women. Considering the low efficacy of AIH and that majority of live births were achieved in the first two cycles, we suggest no more than two AIH treatment attempts for the aged women with DOR.

doi: https://doi.org/10.12669/pjms.39.2.6226

How to cite this: Wang ZY, Huang SX, Yang JD, Li DP, Xu YW. Subfertile Chinese patients with diminished ovarian reserve: An analysis of pregnancy outcomes of ART cycles. Pak J Med Sci. 2023;39(2):338-343. doi: https://doi.org/10.12669/pjms.39.2.6226

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Published
2023-02-15
How to Cite
Wang, Z.-Y., Huang, S.-X., Yang, J.-D., Li, D.-P., & Xu, Y.-W. (2023). Subfertile Chinese patients with diminished ovarian reserve: An analysis of pregnancy outcomes of ART cycles. Pakistan Journal of Medical Sciences, 39(2). https://doi.org/10.12669/pjms.39.2.6226
Section
Original Articles