An estimate of cumulative live birth rates and perinatal outcomes over multiple IVF/ICSI cycles in patients with diminished ovarian reserve at different ages: a retrospective cohort study

Abstract

Abstract Background This study aims to estimate cumulative pregnancy outcomes and perinatal outcomes following frozen-embryo transfer (FET) in diminished ovarian reserve (DOR) patients who could obtain viable embryos with their eggs during in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatments. Methods This study retrospectively analyzed 1230 DOR women undergoing 2055 complete cycles from 2019 to 2021 with follow-up visits until 2022. Cumulative live birth rates (CLBRs) and perinatal outcomes across multiple IVF/ICSI cycles were compared in the study population stratified by age. Results The clinical pregnancy rate (CPR) per ovum pick-up (OPU) cycle for DOR patients in different age groups were 39.1%, 31% and 13.6%, respectively, but the cumulative clinical pregnancy rates (CCPRs) after OPU repeatedly reached 58.4%, 47.3% and 25.6%, respectively. The live-birth rate (LBR) was negatively associated with maternal age, with the highest LBR of 30.2% in younger DOR women (under 32 years of age) and the lowest LBR of 7.9% among women older than 38 years of age. With repeated oocyte retrievals, CLBRs per patient in the three groups reached 52.0%, 43.3% and 18.0%. Based on binary logistic regression, the number of transferred embryos per transfer and type of transferred embryos were positively associated with the CCPR and CLBR. In addition, we found that the incidence of low birth weight was highest in young DOR patients. However, there was no association between DOR and the obstetric outcomes. Conclusions Cumulative pregnancy outcomes following FET were reasonable for DOR patients with different ages using viable embryos derived from autologous oocytes through repeated oocyte retrievals.