Importancia clínica de la asincronía folicular en mujeres con edad materna avanzada sometidas a estimulación ovárica para ICSI

Abstract

Introduction

Women with poor (1-3 oocytes) or suboptimal response (4-9) to ovarian stimulation usually give immature oocytes. When this percentage is bigger than 50%, this situation is known as follicular asynchronism. We focused on women with advanced maternal age and suboptimal response to ovarian stimulation and the relevance that follicular asynchronism could have in ICSI procedure.

Material and methods

We have carried out a retrospective project, between January 2014 - December 2017, in which we have analyse 660 patients with advanced maternal age and who have been subjected to ICSI procedure with own and fresh oocytes. In this group, we found 199 patients who had a poor response and 161 patients with suboptimal response to ovarian stimulation. In the last group, 43 had follicular asynchronism and 418 patients had not this characteristic.

Results

In the group with poor response to ovarian stimulation (199), follicular asynchronism was showed in 25% of them, whereas patients with suboptimal response (461), only the 10% had this characteristic. We did not find significant differences between patients with follicular asynchronism or without this feature, related to fertilization rate or used embryos percentage. In order to obstetrical and gynaecological results, these are similar between groups. We did not realized differences in miscarriage rate (14,28 vs.35,24%) and it had not dissimilarity in labour rate / TE (27,27 vs. 22,44%; N.S.). We only found deviation in newborńs weight, which was fewer in patients without follicular asynchronism because in this group had more multiple gestation than in the group of patients with follicular asynchronism.

Conclusion

To sum up, the number of immature oocytes does not have effect on the rest of mature oocytes in the same cohort, when the patients are women with advanced maternal age and have a suboptimal response to ovarian stimulation, as long as, we only consider fresh transfer.