Abstract
Objective: To study the role of embryo pooling in low ovarian reserve.
Design: Retrospective analysis
Subjects: Forty-six (46) infertility patients with low ovarian reserve
Intervention: We had assessed 46 infertility patients with low ovarian reserve. All patients were started on dehydroepiandrosterone (DHEA) supplements. We had advised IVF with high dose hormones with pooling of embryo for 2 to 3 cycles with the criteria for getting at least 2 grade A embryos. First ovarian stimulation was done with antagonist protocol using Gonadotropins. Second stimulation was started in immediate next cycle with long agonist protocol. In 18 patients out of 46, third ovarian stimulation was done with antagonist protocol.
Main outcome measures: Pregnancy rate, clinical pregnancy rate and live birth rate were assessed.
Results: In 29 females, ovarian stimulation was done twice and in 18, three ovarian stimulations were done to pool embryos. In 3 patients, embryo transfer was not done as response was not good. Overall pregnancy rate was 44.4%, the clinical pregnancy rate was 35.5% and live birth rate was 26.6%.
Conclusions: Fertility treatment of patients with low ovarian reserve is challenging for fertility experts and assisted reproduction technologies are best option for these patients. Embryo pooling is the best option in these cases. But the couples should be properly counselled for the whole process, duration of treatment and the success rate of procedure. Further well-designed studies are required to predict the pregnancy rate and the clinical pregnancy rate more precisely.