Lack of Predictive Value of Ovarian Reserve Tests for Pregnancy Likelihood. The Huge Difference Between Quantity and Quality| Biomed Grid

Objective: To evaluate the predictive value of different variables on the number of achieved oocytes and the likelihood of pregnancy after IVF. Data sources: Prospective cohort study Setting: University associated private AR center. Patients: 718 patients undergoing their first IVF treatment during 2016 and 2017. Interventions: None. Main outcome measures:The study had two objectives. First, to identify factors capable of predicting the quantitative ovarian response of patients by applying a multiple linear regression analysis. Evaluated variables included age, BMI, antral follicle count (AFC), anti-Müllerian hormone (AMH), basal FSH, LH and Estradiol determination, the amount of administered rFSH during ovarian stimulation and Estradiol and Progesterone levels on day of ovulation triggering. Second, to assess, by applying a multivariate logistic analysis, whether the same parameters, plus the number of achieved oocytes, were useful for identifying chances of pregnancy. Results: Whereas AFC was the most accurate factor predicting the number of achieved oocytes, with negligible added value of the remaining variables, age represented the most important factor influencing successful pregnancies. AMH, AFC and achieved oocytes after controlled ovarian stimulation do not predict the probability of pregnancy. Conclusion:Reproductive potential is more related to factors associated to oocyte and embryo quality than the number of achieved oocytes after COS. Our data show that age is the most important variable defining the probability of ongoing pregnancy and that neither AFC nor AMH can be used as criteria for ART exclusion, but as a tool for counselling and proposing different strategies such as oocyte accumulation.