Reproductive Outcome in Patients with Diminished Ovarian Reserve

Objective: To compare reproductive outcome between women with normal ovarian reserve and women with abnormal ovarian reserve.

Design: Retrospective.

Setting: Tertiary care center.

Patient(s): Nine thousand eight hundred and two patients who had basal follicle-stimulating hormone (FSH) concentrations measured as part of an infertility evaluation.

Intervention(s): Monitoring of early pregnancy.

Main Outcome Measure(s): Pregnancy loss rates, live birth rates.

Result(s): Of 1,034 patients with diminished ovarian reserve (DOR) (FSH > or =14.2 IU/L), 28 (2.7%) conceived. Twenty of these pregnancies (20/28; 71.4%) were lost in the first trimester. Pregnancy loss rates in women with DOR were 57.1% in women <35 years old, 63.5% in women 35-40 years old, and 90.0% in women >40 years old. These rates of pregnancy loss were significantly higher compared to age-matched patients with normal ovarian reserve.

Conclusions(s): Women with DOR have exceedingly high rates of pregnancy loss, regardless of age. Women with diminished ovarian reserve should be counseled that, in addition to a low probability of conception, live birth rates are poor.