P-703 Developing individualized treatment strategies using detailed subgroup analysis to optimise pregnancy outcomes for women 40 and above

Abstract Study question What are the prognostic factors and treatment strategies for women 40 and above within different ovarian reserve subgroups? Summary answer Women in each ovarian reserve subgroup have different prognostic factors of pregnancy success and specific treatment strategies are neede...

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Published in:Human reproduction (Oxford) 2022-06, Vol.37 (Supplement_1)
Main Authors: Woon, E.V, Rahman, R, Ibeto, L, MacLaran, K, Norman-Taylor, J, Nikolaou, D
Format: Article
Language:English
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Summary:Abstract Study question What are the prognostic factors and treatment strategies for women 40 and above within different ovarian reserve subgroups? Summary answer Women in each ovarian reserve subgroup have different prognostic factors of pregnancy success and specific treatment strategies are needed for each subgroup. What is known already The number of women 40 and above seeking subfertility treatment is increasing and many are willing to undergo treatment despite extremely poor prognosis. POSEIDON criteria suggested the usage of ovarian reserve and female age as a basis for the study of the management of women in different prognostic categories. However, this classification may not be detailed enough to lead to specific recommendations for individualised management in women 40 and above, as there is rapid decline of oocyte quality and quantity. Large observational studies may lack finer detail due to challenges in recruiting women within different ovarian reserve subgroups. Study design, size, duration We carried out a detailed retrospective analysis of 382 IVF/ICSI cycles for 253 women from January 2019 to December 2021 in a special clinical and academic program for reproductive ageing and fertility. Inclusion criteria were all women who had IVF/ICSI cycles aged 40 and over. Analysis was done for all fresh cycles including cancelled cycles, failed fertilization, no eggs collected and embryo arrest. Cycles resulting in freezing of all embryos were excluded in analysis. Participants/materials, setting, methods The participants were divided into three main subroups: Group A, “normal ovarian reserve” (AMH 2.5-29.9pmol/l, n = 271 cycles); Group B, “extremely poor ovarian reserve” (AMH
ISSN:0268-1161
1460-2350
DOI:10.1093/humrep/deac107.652