Prediction of a poor ovarian response in assisted reproductive technology programs in patients after surgical interventions on the ovaries

The aim. To conduct a comparative analysis of clinical and anamnestic data in women of reproductive age after ovarian cyst surgery and with occult premature ovarian insufficiency (POI) to predict a poor ovarian response to stimulation. Materials and methods. We conducted a retrospective study of medical records of women (aged 18-40 years) with infertility at the Assisted Reproductive Technology Center of Siberian State Medical University from 2017 to 2020. The main group consisted of 84 patients who underwent ovarian cyst surgery. The comparison group consisted of 33 patients with biochemical signs of POI (follicle stimulating hormone (FSH) 10-12 mMU / ml) who did not undergo ovarian cyst surgery. Anti-Mullerian hormone (AMH), FSH, estradiol, the antral follicle count (AFC), and the ovarian response to stimulation were compared. Results. A correlation was established between AFC and a poor ovarian response both in the main group (r = -0.7; p = 0.004) and in the comparison group (r = -0.620; p = 0.000) in women under 35 years of age. A correlation was found between the concentration of estradiol and a poor ovarian response in the comparison group in women over 35 years of age (r = -0.707; p = 0.001). A moderate negative correlation between AMH and a poor ovarian response was revealed only in the main group of women under the age of 35 years (r = -0.589; p = 0.021). A moderate negative correlation between AMH and a poor ovarian response was revealed in the comparison group in women under the age of 35 years (r = -0.648; p = 0.000), a weak negative correlation was found for women at the age of 35 years (r = -0.500; p = 0.004). In both groups, the level of FSH did not determine the ovarian response to stimulation. Conclusion. The determination of AFC and AMH is more significant in predicting a poor ovarian response in women after ovarian surgery and in women with occult signs of POI under the age of 35 years, compared with FSH. In the group of women over 35 years with occult signs of POI, the concentration of estradiol may matter in predicting a poor ovarian response, which requires further research.