The effect of the pooling method on the live birth rate in poor ovarian responders according to the Bologna criteria

Turk J Obstet Gynecol. 2018 Mar;15(1):39-45. doi: 10.4274/tjod.62447. Epub 2018 Mar 29.

Abstract

Objective: Pooling is an alternative method to achieve in vitro fertilization outcomes. This study was to investigate the effect of pooling method on pregnancy outcomes in poor responder patients according to Bologna criteria.

Materials and methods: Two hundred-fifty five poor responder patients were enrolled in this study. Pooling embryo transfer (ET) group had 110 and fresh ET group had 145 patients.

Results: Although, age was similar between both treatment groups (p=0.31), antral follicle count (p<0.001), total number of retrieved oocyte (p<0.001), total metaphase II oocyte count (p<0.001), number of stimulation cycles (p<0.001), were significantly different between the groups. The day of ET were similiar between two groups (p=0.72) but the number of ET procedure was significantly higher in pooling ET group compared to fresh ET (p<0.001). Positive pregnancy test [35/110 (32%) vs 53/145 (37%)] (p=0.43) and clinical pregnacy rates [31/110 (28%) vs 49/145 (34%)] (p=0.33) were similar between groups, whereas, implantation [31/191 (16%) vs 49/198 (25%)] (p=0.03) and live birth rates [15/110 (14%) vs 36/145 (25%)] (p=0.04) were significantly higher in fresh ET group. Despite that, abortion rates were significantly higher in pooling ET group [16/31 (52%) vs 13/49 (27%)] (p=0.04). Binary logistic regression analyese has revealed no effect of variables on live birth rates.

Conclusion: Even though, pooling strategy seems to have a slight positive effect on pregnancy outcomes, there is no benefical effect on live birth rates. Furthermore, this strategy is increasing the abortion rates in parallel with clinical pregnancy rates.

Keywords: Poor responder; frozen embryo transfer; in vitro fertilization.