A Study to Determine the Impact of Diminished Oocyte Reserve (DOR) on Pregnancy Outcome in Women of Advanced Reproductive Age

Background: Both advancing age and diminished oocyte reserve (DOR) have a negative impact on fecundity. Objective: To determine what effect diminished oocyte reserve (DOR), as determined by low anti-Mullerian hormone levels, has on live delivered pregnancy rates following in vitro fertilization embryo transfer (IVF-ET) in women aged-40-42. Design: This was a retrospective study. Materials and Methods: A retrospective study was performed in women aged 40-42 undergoing IVF-ET with DOR or normal ovarian reserve (NOR). The women were divided into two groups based on egg reserve: DOR (anti-mullerian hormone (AMH) level <1 ng/ml) and normal oocyte reserve (NOR) (serum AMH ≥ 1ng/ml). A type of mild ovarian stimulation protocol, known as the FSH receptor up-regulation technique, was used for women with DOR. Setting: University-associated private practice IVF center. Results: The live delivered pregnancy rate (LDPR) was 12.6% for the DOR group and 12.9% for normal oocyte reserve (NOR). Conclusion: Since the LDPRs were the same for women aged 40-42 with DOR compared to NOR, a low serum AMH should not be a deterrent for performing IVF-ET in women aged 40-42. If this LDPR is not acceptable, then one could consider the use of donor eggs.