Impact of Age on Ovarian Response and IVF Outcome during Controlled Ovarian Hyperstimulation in Women from Gaza Strip

Background: Although age is an important factor in female fertility, not much date were focused on the relationship between age and ovarian response and in vitro fertilization (IVF) outcome. However, the female reproductive capacity varies with age. Objective: To assess the impact of age on ovarian response and IVF outcome during controlled ovarian hyperstimulation in women from Gaza Strip. Methods: This prospective cohort study consisted of 75 women attending IVF at Al-Basma Fertility Center in Gaza City. The number of oocytes and embryos were recorded for each female and the occurrence of pregnancy was followed for three months. The obtained data were computer analyzed using SPSS statistical package version 18. Results: The mean age of the study population was 29.2±5.9 years. The total number of oocytes was significantly decreased with increasing age (F= 3.932 and P= 0.024). In this context Pearson correlation test exhibited negative significant correlation between women age and the number of mature oocyte (r=-0.276, P= 0.017). There was an inverse relationship between age and ovarian response (F= 6.773 and P= 0.001), showing good response (9-16 oocytes) at mean age of 26.7±5.0 years. When related to women age, IVF outcome showed that the chance of getting pregnant increased with decreased age (F= 4.278 and p= 0.018). Conclusion: The ovarian response and the chance of getting pregnancy were diminishing with ageing, implying that maternal age should by consider during IVF program

Serum Estradiol Level as a Predictor of Ovarian Response and Pregnancy Outcome During Controlled Ovarian Hyperstimulation in Women from Gaza Strip

Background: Currently, controlled ovarian hyperstimulation (COH) is monitored by serum estradiol (E2) levels which are believed to primarily detect functional activity of follicles. Objective: To evaluate estradiol level as a predictor of ovarian response and pregnancy outcome during COH in women from Gaza Strip. Methods: This prospective cohort study consisted of 75 women attending in vitro fertilization (IVF) at Al-Basma Fertility Center in Gaza City. Blood withdrawal for E2 hormone measurement was performed in all the patients and the number of oocytes and embryos were recorded for each female and the occurrence of pregnancy was followed for three months. Obtained data were computer analyzed using SPSS statistical package version 18. Results: The mean age of the study population was 29.2±5.9 years. Questionnaire interview showed that the cause of infertility was mostly referred to husbands. More than half of women seeking IVF had no children and had repeated IVF. The mean level of E2 showed the highest value of 2194.4 (pg/ml) at age group 26-35 years. However, the difference in E2 levels among the age groups was not significant (F= 0.940 and P= 0.395). When related to the number of oocytes retrieved, E2 level showed general increase with increase ovarian response, recording values of 1642.7, 1665.1, 2156.8 and 1798.7 pg/ml with 16 oocytes, respectively, but this change was not significant (F= 0.219 and P= 0.883). The mean level of E2 showed its maximum value of 2143.6 pg/ml in positive pregnancy. However the difference in E2 levels among the different categories of IVF outcome was not