Clinic Analyses Of Successful And Previous Failed ICSI Cycle Parameters In Cases With Poor Ovarian Reserve

Aim: To figure out some major characteristic differences between two consecutive successful and unsuccessful ICSI cycles in poor responders.
Methods: Sixty women with poor ovarian response determined by Bologna criteria underwent ICSI cycle following an unsuccessful trial. Some parameters of both cycles including age, BMI, serum FSH and estradiol levels, antral follicle count, stimulation protocol, gonadotropin dosage, duration of stimulation, antagonist starting day, duration of antagonist administration, endometrial thickness at trigger day, number of total and fertilized oocytes, the embryo transfer day, number of embryo cells, fertilization rate were compared in same cases to figure out predictors of cycles with clinical pregnancy.
Results:
Mean age, BMI, serum FSH, estradiol concentrations, antral follicle count were 35.9 (30-42 years), 25.9 (18.4-33.5 kg/m2), 10.9 (2.6-13), 52.9 (11.6-252 pg/ml), 4.7 (2-10) respectively. Comparison of some cycle characteristics showed significantly higher number of total, mature and fertilized oocyte numbers in successful cycle. Fertilization rate was also significantly higher in cycle with clinical pregnancy. Early antagonist initiation was shown to result in favorable outcome. Comparison of some embryo characteristics showed that transfer of higher stage of embryo and embryo with higher number of cells had significant impact on cycle outcome.

Conclusion: Comparison of some parameters of failed and successful ICSI cycles in poor responders revealed significantly earlier antagonist initiation, higher number of total, mature and fertilized oocytes, fertilization rate, significantly higher stage of embryo development and cell number at transfer in cycles with clinical pregnancy.
Key words: poor responders, assisted reproduction, fertilization rate, gonadotropin releasing hormone antagonist