The Impact of Ovarian Reserve, Aneuploidy Rates, and Maternal Age on IVF Success

Marina S. Rodrigues¹; Fernando P. Ferreira¹ ²; Claudio E. Bonduki²; Edson G. Lo Turco¹ ³

1. Department of Gynecology, Neo Vita Clinic, São Paulo, Brazil

2. Department of Gynecology, São Paulo Federal University, São Paulo, Brazil

3. Department of Surgery - Division of Urology - Human Reproduction Section, São Paulo Federal University, São Paulo, Brazil

Abstract Text:

Previous studies have established that women with poor ovarian response produce embryos with a higher risk of aneuploidy than women with normal response. This may be because the oocytes of poor quality are the last to remain in the ovary and have been in meiosis for a longer period, which increases the risk of chromosomal abnormalities. Preimplantation Genetic Testing (PGT) may help to enhance implantation and pregnancy rates in poor responders by selecting genetically fit embryos and, thereby, excluding aneuploid embryos that may result in miscarriages and reproductive failure.

A retrospective study was conducted involving 1,703 patients who underwent infertility treatments and Preimplantation Genetic Testing (PGT) at Neo Vita Clinic between 2019 and 2024. Patients were classified into two groups based on age; those above and those below 37 years. After informed consent and meeting inclusion/exclusion criteria, medical records were analyzed. The Student's t-test and Chi-square test were used for statistical analysis with SPSS 8.0 software to compare the groups.

There were no significant differences in euploid rates between poor and normal responders, irrespective of age. Both groups had almost equal euploid rates: 16.65% ± 2 for patients < 37 years of age and 43.3% ± 3 for patients ≥37 years of age. However, the poor responder group had a higher percentage of biopsied blastocysts, with 13.7% ± 2 in the < 37 age group and 10.6% ± 4 in the >37 age group. This means that poor responders are more likely to subject their embryos to Preimplation Genetic Testing for Aneuploidies (PGT-A). 

It could be that poor responders, who have fewer and potentially poorer quality oocytes, stand to gain the most from genetic screening in order to steer clear of embedding aneuploid embryos and thus improve the chances of pregnancy and reduce the risk of miscarriage. Although the euploid rates are comparable between the groups, the higher biopsy rates suggest that they require more specific strategies to enhance the chances of fertility treatment.