The Predictive Potential of Ovarian Reserve Markers for Poor Responders in the Assisted Reproductive Treatment Outcomes

Öz

To evaluate the predictive power of baseline age, FSH, AMH, and AFC on total retrieved oocyte numbers and treatment outcomes in women with poor ovarian response (POR) according to the Bologna criteria. In this retrospective study, 181 IVF cycles meeting the Bologna POR criteria were analyzed at the Eskişehir Osmangazi University Reproductive Health Center between January 2017 and December 2024. Baseline parameters (age, FSH, AMH, AFC) were correlated with total and MII oocyte counts using correlation and logistic regression analyses. POR prediction (≤3 retrieved oocytes) was assessed by ROC analysis. Pregnancy outcomes (biochemical, clinical pregnancy, live birth) were recorded based on serum β-hCG measurements 12 days post-transfer and ultrasonographic findings. The mean age was 35.9 ± 4.6 years, basal FSH 9.9 ± 4.1 IU/L, AMH 0.88 ± 0.33 ng/mL, and AFC 5.5 ± 2.5. Mean total oocyte count was 2.54 ± 1.28 and MII oocyte count 1.50 ± 1.27. AFC showed a significant correlation with total oocyte count (r = 0.247, p < 0.001). AMH (AUC = 0.716, p = 0.003) and FSH (AUC = 0.687, p = 0.002) predicted POR cycles with ≤3 oocytes, demonstrating slightly lower AUC values compared to AFC. Clinical pregnancy rate was 28.9% and live birth rate was 18.1%. In women with POR, AFC was the strongest predictor of oocyte yield, while AMH and FSH showed comparable and higher performance in identifying very POR cycles. These findings underscore the importance of combined assessment of basal ovarian reserve markers for personalized IVF protocol planning

Anahtar Kelimeler

• ovarian reserve
• amh
• afc
• fsh
• bologna
• poor ovarian response
• ivf

Yardımcı Üreme Tedavisi Sonuçlarında Zayıf Yanıt Veren Olgularda Over Rezerv Belirteçlerinin Öngörü Potansiyeli

Öz

Bu çalışmanın amacı, Bologna kriterlerine göre düşük over yanıtı tanısına uyan kadınlarda bazal yaş, FSH, AMH ve AFC değerlerinin toplanan oosit sayısı bağlantılı tedavi sonuçlarını öngörme gücünü değerlendirmektir. Eskişehir Osmangazi Üniversitesi Üreme Sağlığı Merkezi’ne Ocak 2017–Aralık 2024 tarihleri arasında başvuran, Bologna kriterlerine göre düşük over yanıt durumuna sahip 181 tüp bebek siklusu retrospektif olarak incelendi. Bazal parametreler (yaş, FSH, AMH, AFC) ile toplanan oosit sayıları arasındaki ilişki korelasyon ve lojistik regresyon analizleri ile; çok düşük over yanıtı (≤3 oosit) öngörüsü ROC analizi ile değerlendirildi. Gebelik sonuçları (biyokimyasal, klinik gebelik, canlı doğum) embriyo transferinden 12 gün sonraki β-hCG ve ultrasonografik bulgulara göre kaydedildi. Katılımcıların ortalama yaş 35.9±4.6 yıl, bazal FSH 9.9±4.1 IU/L, AMH 0.88±0.33 ng/mL, AFC 5.5±2.5 olarak tespit edildi. Ortalama toplam oosit sayısı 2.54±1.28, matür oosit sayısı 1.50±1.27 idi. AFC, toplam oosit sayısı ile anlamlı korelasyon (r=0.247, p<0.001) gösterirken; AMH (AUC=0.716, p=0.003) ve FSH (AUC=0.687, p=0.002) 3 ve altı oosit elde edilen döngüleri öngörmede AFC’ye göre daha yüksek öngörü potansiyeli sergiledi. Klinik gebelik oranı %28.9, canlı doğum oranı %18.1 olarak bulundu. Düşük over yanıtlı vakalarda AFC, toplam oosit sayısını öngörmede en güçlü belirteç iken; düşük yanıtlı döngülerin tanımlanmasında AMH ve FSH değerleri AFC’den daha iyi bir öngörü potansiyeli gösterdi. Bu veriler, IVF protokollerinin kişiselleştirilmesinde bazal over rezerv belirteçlerinin birlikte değerlendirilmesinin önemini vurgulamaktadır.

Anahtar Kelimeler

• over rezerv
• düşük over yanıtı
• tüp bebek
• amh
• amh
• afc
• afc
• fsh
• fsh
• bologna
• bologna

Kaynakça

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