What did change in poor ovarian responders according to Bologna criteria over the 5 years? A tertiary IVF center experience

Abstract

INTRODUCTION: The objective of the study was to evaluate the changes in the prevalence, management strategies, and cycle outcomes of the cycle with the poor ovarian response (POR). METHODS: This study was retrospectively designed. Poor responder infertile women who fulfilled Bologna criteria were included in the study. Data were obtained from medical records of infertile couples who underwent the intracytoplasmic sperm injection and embryo transfer program from January 2014 to December 2018. RESULTS: Totally 776 cycles with POR were evaluated. The changing trend in the prevalence of the cycle with POR was estimated by rejecting the null hypothesis that there is no linear trend in the proportion of poor cycles across years (χ2(1)=9.28, p=0.002). A linear increasing trend in the proportion of poor cycles in the 5 years was found. A linear increase in the prefer of the antagonist protocol was found (χ2(1)=6.61, p=0.010), whereas there was a linear decrease in the minimal stimulation protocol with Clomiphene Citrate (χ2(1)=11.028, p<0.001). An increase in the usage of recombinant follicle-stimulating hormone (rFSH)/human menopausal gonadotropin (HMG) together was found (χ2(1)=76.28, p<0.001), whereas there was a decrease in the usage of the only FSH or HMG (χ2(1)=18.11 p<0.001; χ2(1)=18.62, p<0.001). There was no change in the trend of cycle outcomes during 5 years period. DISCUSSION AND CONCLUSION: There is a clear increasing trend in the prevalence of cycles with POR over the 5 years. Ovarian stimulation protocols and choice of gonadotropins have shown a changing trend.