TY - JOUR T1 - Factors affecting pregnancy rates in IVF patients with low ovarian reserve: the role of anti-Müllerian hormone and antral follicle count TT - Düşük over rezervi tanısı alan hastalarda gebeliği etkileyen faktörler AU - Turan Bakırcı, Işıl AU - Cok, Mehmet AU - Bolluk, Gökhan AU - Aytufan, Zübeyde AU - Köroğlu, Nadiye AU - Özdemir, İsmail PY - 2025 DA - February Y2 - 2025 DO - 10.47582/jompac.1605961 JF - Journal of Medicine and Palliative Care JO - J Med Palliat Care / JOMPAC / Jompac PB - MediHealth Academy Yayıncılık WT - DergiPark SN - 2717-7505 SP - 45 EP - 49 VL - 6 IS - 1 LA - en AB - Aims: This study evaluated in vitro fertilization (IVF) pregnancy rates in patients with low ovarian reserve (LOR), compared pregnancy rates between patients with very low and low anti-Müllerian hormone (AMH) levels, and identified factors affecting pregnancy outcomes. Methods: We analyzed 311 IVF cycles in 217 women with LOR. Patient selection followed the Bologna criteria for poor ovarian response. We compared the pregnant (n=22) and non-pregnant (n=289) groups for AMH, antral follicle count (AFC), oocyte parameters, and clinical outcomes. Multivariate logistic regression identified the independent predictors of pregnancy success. Results: Pregnant patients showed higher AFC (4.6±2.4 vs 3.4±2.3, p=0.008) and AMH values (0.6±0.2 vs 0.4±0.3 ng/ml, p=0.024). Patients with AMH ≤0.5 ng/ml had higher cycle cancellation rates (26.1% vs. 4.2%, p KW - Low ovarian reserve KW - anti-Müllerian hormone KW - infertility KW - pregnancy rate KW - in vitro fertilization N2 - Amaç: Bu çalışmada, düşük over rezervi (LOR) nedeniyle in vitro fertilizasyon (IVF) uygulanan hastaların gebelik oranları değerlendirilmiş, çok düşük ve düşük anti-Müllerian hormon (AMH) düzeyleri olan hastalar arasında gebelik oranları karşılaştırılmış ve gebelik başarısını etkileyen faktörler belirlenmiştir.Yöntem: LOR tanısı olan 217 kadında toplam 311 IVF siklusu analiz edilmiştir. Hasta seçimi, kötü over yanıtı için belirlenen Bologna kriterlerine göre yapılmıştır. Gebe kalan (n=22) ve kalamayan (n=289) hastalar; AMH, antral folikül sayısı (AFC), oosit parametreleri ve klinik sonuçlar açısından karşılaştırılmıştır. Çok değişkenli lojistik regresyon analizi ile gebelik başarısını bağımsız olarak etkileyen faktörler belirlenmiştir.Bulgular: Gebe kalan hastalarda, daha yüksek AFC (4.6±2.4'e karşı 3.4±2.3, p=0.008) ve AMH değerleri (0.6±0.2'ye karşı 0.4±0.3 ng/mL, p=0.024) gözlenmiştir. AMH düzeyi ≤0.5 ng/mL olan hastalarda siklus iptal oranları (%26.1'e karşı %4.2, p CR - Vander Borght M, Wyns C. Fertility and infertility: definition and epidemiology. Clin Biochem. 2018;62:2-10. doi:10.1016/j.clinbiochem. 2018.03.012 CR - Kondagari L, Kahn J, Singh M. Sonography gynecology infertility assessment, protocols, and interpretation. 2023 Jun 7. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan. CR - Ubaldi FM, Cimadomo D, Vaiarelli A, et al. Advanced maternal age in IVF: still a challenge? The Present and the future of ıts treatment. Front Endocrinol (Lausanne). 2019;10(20):94. doi:10.3389/fendo.2019.00094 CR - Makoyo O, Moungala LW, Lendoye E. Ovarian reserve of infertile women in Libreville: a retrospective analysis of 124 cases at the University Mother and Child Hospital in Libreville, Gabon. Afr J Reprod Health. 2023;27(3):19-24. doi:10.29063/ajrh2023/v27i3.2 CR - Pacheco A, Cruz M, Iglesias C, García-Velasco JA. Very low anti-müllerian hormone concentrations are not an independent predictor of embryo quality and pregnancy rate. Reprod Biomed Online. 2018;37(1): 113-119. doi:10.1016/j.rbmo.2018.03.015 CR - Gottardo F, Kliesch S; World Health Organization. Ejakulatdiagnostik: spermiogramm nach WHO-Kriterien 2010 [Semen analysis: spermiogram according to WHO 2010 criteria]. Urologe A. 2011;50(1): 101-1088. doi:10.1007/s00120-010-2466-6 CR - Pastore LM, Christianson MS, Stelling J, Kearns WG, Segars JH. Reproductive ovarian testing and the alphabet soup of diagnoses: DOR, POI, POF, POR, and FOR. J Assist Reprod Genet. 2018;35(1):17-23. doi: 10.1007/s10815-017-1058-4 CR - Huang Y, Li J, Zhang F, et al. Factors affecting the live-birth rate in women with diminished ovarian reserve undergoing IVF-ET. Arch Gynecol Obstet. 2018;298(5):1017-1027. doi:10.1007/s00404-018-4884-4 CR - Fanton M, Cho JH, Baker VL, Loewke K. A higher number of oocytes retrieved is associated with an increase in fertilized oocytes, blastocysts, and cumulative live birth rates. Fertil Steril. 2023;119(5):762-769. doi:10. 1016/j.fertnstert.2023.01.001 CR - La Marca A, Donno V, Longo M, et al. Predicting the total number of retrieved oocytes following double ovarian stimulation (DuoStim). Hum Reprod. 2023;38(9):1784-1788. doi:10.1093/humrep/dead148 CR - Scheffer JB, Carvalho RF, Aguiar APS, et al. Which ovarian reserve marker relates to embryo quality on day 3 and blastocyst; age, AFC, AMH? JBRA Assist Reprod. 2021;25(1):109-114. doi:10.5935/1518-0557. 20200060 CR - Arvis P, Rongières C, Pirrello O, Lehert P. Reliability of AMH and AFC measurements and their correlation: a large multicenter study. J Assist Reprod Genet. 2022;39(5):1045-1053. doi:10.1007/s10815-022-02449-5 CR - Zhang Y, Xu Y, Xue Q, et al. Discordance between antral follicle counts and anti-Müllerian hormone levels in women undergoing in vitro fertilization. Reprod Biol Endocrinol. 2019;17(1):51. doi:10.1186/s12958-019-0497-4 CR - Abdalla H, Thum MY. An elevated basal FSH reflects a quantitative rather than qualitative decline of the ovarian reserve. Hum Reprod. 2004;19(4):893-898. doi:10.1093/humrep/deh141 CR - Romanski PA, Gelvin B, Bortoletto P, Rosenwaks Z, Kang HJ. Live-birth outcomes among women with ınfertility and anti-Müllerian hormone levels of 0.3 ng/ml or lower. Obstet Gynecol. 2022;140(5):743-750. doi:10. 1097/AOG.0000000000004895 CR - La Marca A, Nelson SM, Sighinolfi G, et al. Anti-Müllerian hormone-based prediction model for a live birth in assisted reproduction. Reprod Biomed Online. 2011;22(4):341-349. doi:10.1016/j.rbmo.2010.11.005 CR - Broer SL, van Disseldorp J, Broeze KA, et al. Added value of ovarian reserve testing on patient characteristics in the prediction of ovarian response and ongoing pregnancy: an individual patient data approach. Hum Reprod Update. 2013;19(1):26-36. doi:10.1093/humupd/dms041 CR - Nelson SM, Klein BM, Arce JC. Comparison of antimüllerian hormone levels and antral follicle count as predictor of ovarian response to controlled ovarian stimulation in good-prognosis patients at individual fertility clinics in two multicenter trials. Fertil Steril. 2015;103(4):923-930.e1. doi:10.1016/j.fertnstert.2014.12.114 CR - Iliodromiti S, Anderson RA, Nelson SM. Technical and performance characteristics of anti-Müllerian hormone and antral follicle count as biomarkers of ovarian response. Hum Reprod Update. 2015;21(6):698-710. doi:10.1093/humupd/dmu062 CR - Greene AD, Patounakis G, Segars JH. Genetic associations with diminished ovarian reserve: a systematic review of the literature. J Assist Reprod Genet. 2014;31(8):935-946. doi:10.1007/s10815-014-0257-5 UR - https://doi.org/10.47582/jompac.1605961 L1 - https://dergipark.org.tr/tr/download/article-file/4461041 ER -