A low number of retrieved oocytes at in vitro fertilization treatment is predictive of early menopause.

Abstract

PATIENT(S)

Women participating in a nationwide Dutch cohort study (OMEGA) of ovarian stimulation for IVF and subsequent gynecologic diseases (n = 26,428). Each patient who experienced natural menopause at or before 46 years (n = 38) was individually matched to five controls (n = 190) who had not yet entered menopause at the age the patient became postmenopausal.

OBJECTIVE

To investigate whether women with a low number of retrieved oocytes at the first in vitro fertilization (IVF) attempt have an increased risk of early menopause.

RESULT(S)

Women with a poor response (zero to three oocytes) had a relative risk of 11.6 (95% confidence interval: 3.9-34.7) of having an early menopause as compared with women who have a normal response (> three oocytes). Women who were stimulated with gonadotropins during IVF treatment but did not undergo an IVF puncture because of an anticipated poor response (canceled IVF cycle) had a relative risk of 8.3 (95% confidence interval: 2.9-23.9).

DESIGN

Nested case-control study.

CONCLUSION

These results suggest that women with a low number of retrieved oocytes at the first IVF treatment are more likely to become postmenopausal at an early age than women with a higher number of retrieved oocytes. Our study is the first longitudinal study to provide strong evidence for the quantitative aspect of the ovarian concept of reproductive aging.

INTERVENTION(S)

None.

SETTING

Twelve IVF clinics in the Netherlands.

MAIN OUTCOME MEASURE(S)

Relative risk of reaching natural menopause at an early age (</=46 years), according to the number of retrieved oocytes at the first IVF attempt.