Ovarian Reserve Score and Assisted Reproductive Therapy Outcome

Objective: This study was carried out to evaluate the value of ovarian reserve score (ORS) as a predictive value of outcome of assisted reproduction therapy (ART).Study Design: This prospective study was done at Al-Azhar University Hospitals and International Islamic Center for Population Studies and Research (IICPSR) and included 350 infertile women who had undergone assisted reproduction therapy in the period from November 2009 to December 2010. All women were subjected to clinical evaluation and measuring of basal FSH, E2 and AMH at day 3 of the cycle prior to controlled ovarian hyperstimulation. Ultrasound scanning was performed on the same day to assess Antral Follicles Count (AFC) and the Mean Ovarian Volume (MOV). Every woman was given a score called Ovarian Reserve Score (ORS) according to a special Table. Then, in the next cycle, Controlled Ovarian Hyperstimulation (COH) using long term protocol was applied. Ovulation response, number of retrieved oocytes, number of transferred embryos and pregnancy rate were recorded and tabled.Results: The results of this study documented the importance of maternal age as one of the good predictors of ovarian reserve. As the maternal age goes beyond thirty years, there was decline in the ovarian reserve with subsequent poor response to gonadotrophin. The ORS has a good predictive value as women with ORS 3; all are poor responders to COH, women with ORS 3; had good response, women with ORS 3 are borderline responders and women with ORS 9; all are high responders and a high risk for Ovarian Hyper Stimulation Syndrome (OHSS). Also ORS has a good predictive value as regard to number of follicles, retrieved oocytes and pregnancy rate.Conclusion: In light of our findings, we can use ORS for prediction of poor response to COH and counseling the couples regards their performance during ovarian stimulation. Also ORS can be used to adjust the dose of human menopausal gonadotrophins to get the optimum response.