Effect of Repeated Assisted Reproductive Technology Cycles on Ovarian Response

Objective: To assess the effect of repeated assisted reproductive technology (ART) cycles on the ovarian response in patients treated with human menopausal gonadotropins and GnRH agonists.

Design: Retrospective analysis.

Setting: Tertiary referral center.

Patient(s): Three thousand two hundred forty-nine patients who had completed at least two in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) cycles (minimum two, maximum six cycles per patient).

Intervention(s): Nine thousand three hundred seventy-nine repeated IVF/ICSI cycles.

Main Outcome Measure(s): Mean number of cumulus oocyte complexes (COC) retrieved per cycle, mean number of ampules used per attempt.

Result(s): Repeated ART cycles did not exert a significant effect on the mean number of COC retrieved per attempt in contrast to maternal age, which was inversely related to the mean number of COC retrieved in all cycles performed. Across repeated ART attempts, an increase in the mean number of ampules used per cycle was observed. This was due to an effect of maternal age, which increased in line with the mean number of ampules used per cycle, as well as to an age-independent effect of repeated cycles.

Conclusion(s): An age-independent deterioration of the ovarian response appears to occur across repeated ART cycles.