Factors affecting pregnancy rates in IVF patients with low ovarian reserve: the role of anti-Müllerian hormone and antral follicle count

Yıl 2025, Cilt: 6 Sayı: 1, 45 - 49, 14.02.2025

Mehmet Cok , Işıl Turan Bakırcı , Gökhan Bolluk , Zübeyde Aytufan , Nadiye Köroğlu , İsmail Özdemir

https://doi.org/10.47582/jompac.1605961

Öz

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<0.001), and clinical pregnancy rates remained similar between the AMH groups (6% vs. 8.3%, p=0.421). Multivariate analysis identified AFC (OR: 1.32, 95% CI: 1.08-1.62, p=0.007) and oocyte count (OR: 1.28, 95% CI: 1.05-1.56, p=0.015) as independent predictors of pregnancy success.
Conclusion: In our clinic, AMH levels predicted ovarian response, but not pregnancy outcomes, in patients with LOR. AFC and oocyte count were better predictors of successful IVF.

Anahtar Kelimeler

Low ovarian reserve, anti-Müllerian hormone, infertility, pregnancy rate, in vitro fertilization

Düşük over rezervi tanısı alan hastalarda gebeliği etkileyen faktörler

Öz

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<0.001) daha yüksek bulunmuş, ancak klinik gebelik oranları AMH grupları arasında benzer kalmıştır (%6'ya karşı %8.3, p=0.421). Çok değişkenli analiz sonucunda, AFC (OR: 1.32, %95 GA: 1.08-1.62, p=0.007) ve oosit sayısı (OR: 1.28, %95 GA: 1.05-1.56, p=0.015), gebelik başarısının bağımsız belirleyicileri olarak tanımlanmıştır.

Sonuç: Bu çalışmada, AMH düzeylerinin düşük over rezervine sahip hastalarda ovaryan yanıtı öngördüğü, ancak gebelik sonuçlarını öngörmede yetersiz kaldığı belirlenmiştir. AFC ve oosit sayısı ise başarılı IVF sonuçlarının daha güçlü öngörücüleri olarak öne çıkmıştır.

Anahtar Kelimeler

Düşük Over Rezervi, Anti-Müllerian Hormon, İnfertilite, Gebelik Oran, İn Vitro Fertilizasyon

Kaynakça

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