Maternal age and progesterone levels at trigger day as independent predictors of clinical pregnancy in poor ovarian responders undergoing IVF/ICSI: a retrospective analysis

TL;DR

This study finds that maternal age and progesterone levels on a specific day during IVF/ICSI are key factors in predicting pregnancy success for poor ovarian responders.

Contribution

The study identifies maternal age and trigger day progesterone levels as independent predictors of clinical pregnancy in poor ovarian responders undergoing IVF/ICSI.

Findings

Maternal age was an independent predictor of clinical pregnancy (adjusted OR: 1.035; P=0.047).

Progesterone levels at the trigger day were an independent predictor of clinical pregnancy (adjusted OR: 1.422; P=0.034).

Clinical pregnancy rate was 5.5% among 652 poor ovarian responders.

Abstract

Poor ovarian response (POR) during in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) significantly compromises clinical pregnancy outcomes. This study evaluated the clinical characteristics and outcomes of IVF/ICSI cycles in poor ovarian responders, focusing specifically on maternal age and progesterone levels at the trigger day as predictors of clinical pregnancy.

This retrospective study included 652 poor ovarian responders treated with IVF/ICSI between January 2018 and December 2021 at a tertiary fertility center. POR was defined according to the Bologna criteria. Various ovarian stimulation protocols (antagonist, modified natural cycle, short agonist, and long agonist protocols) were employed based on individualized patient assessment. Demographic data, ovarian stimulation details, cycle outcomes, and hormonal levels at trigger day were analyzed. Multivariate logistic regression was performed to identify independent predictors of clinical pregnancy.

Of the 652 patients analyzed, the clinical pregnancy rate was 5.5%. Age, body mass index (BMI), stimulation protocols, and other clinical variables showed no significant differences between pregnant and non-pregnant groups. Multivariate logistic regression analysis identified maternal age (adjusted OR: 1.035; 95% CI: 1.024–1.078; P=0.047) and progesterone levels at the trigger day (adjusted OR: 1.422; 95% CI: 1.380–1.564; P=0.034) as independent predictors of clinical pregnancy.

Maternal age and progesterone levels on the trigger day are independent predictors of clinical pregnancy in poor ovarian responders undergoing IVF/ICSI. Tailoring ovarian stimulation strategies according to these predictive factors may enhance clinical outcomes in this challenging patient population. Further studies exploring advanced techniques and individual patient characteristics are necessary to optimize management strategies for POR patients.

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