Effect Of Repeated COS-IVF/ICSI Treatment On Ovarian Reserve And Ovarian Reaction

BackgroundDuring the treatment of in-vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI), patients usually have to receive large doses of follicle-stimulating hormone (FSH) for control ovarian stimulation (COS) and follicle punctures and aspiration surgery. The damage might be cumulated as the number of IVF/ICSI cycle increased, thus affecting the ovarian reaction and reserve.Although the success rate of assisted reproductive technology (ART) has increased significantly in recent decades, there still some patients need repeated COS-IVF/ICSI to obtain a live birth. Some studies have suggested that, ovarian reserve, oocyte quantity and embryo quality will change during the repeated COS-IVF/ICSI cycles. However, some other studies have shown that the ovarian reaction and reserve were primarily related to the age, and there is no negative impact on young patients. Thus, whether the repeated stimulation of super-physiological dose of FSH and follicular puncture affect on the ovarian reaction has become a important question in ART clinic. ObjectiveTo investigate the possible effect of repeated COS-IVF/ICSI treatment on ovarian reaction and ovarian reserve, and provide certain evidences for future clinical work.DesignRetrospective analysis of data from two ART centresSettingDepartment of Reproductive Endocrinology, Women’s Hospital, School of Medicine, Zhejiang University; Center of Reproductive medicine, and Women and Children Hospital of HuzhouMethods129infertile couples, a total of387cycles, each of them underwent three times of COS-IVF/ICSI treatments, were evaluated retrospectively. Retrospective analysis the effect of repeated COS-IVF/ICSI on the basal FSH; AFC, dosage of gonadotropin (GN) required, the number of oocytes retrieved, fertilization rate and the good quality embryo rate.Main outcome measuresFertilization rate; basal FSH; AFC, high quality embryo rate; dosage of gonadotropin; number of oocytes retrieved; high quality embryo rate.ResultsThe results showed no statistically significant differences among the all three cycles (P>0.05) in terms of the number of oocytes retrieved, basal FSH, antral follicle count (AFC), fertilization rate and the high quality embryo rate. However, it was found that the dosage of GN was significantly higher in the second and third cycle than the first cycle (p<0.05).ConclusionRrepeated COS-IVF/ICSI treatment has no significantly adverse impact on the ovarian reserve, but ovarian reactivity could be influenced.