Objective: To investigate whether women with a low number of retrieved oocytes at the first in vitro fertilization (IVF) attempt have an increased risk of early menopause. Design: Nested case-control study. Setting: Twelve IVF clinics in the Netherlands. Patient(s): Women participating in a nationwide Dutch cohort study (OMEGA) of ovarian stimulation for IVF and subsequent gynecologic diseases (n = 26,428). Each patient who experienced natural menopause at or before 46 years (n = 38) was individually matched to five controls (n = 190) who had not yet entered menopause at the age the patient became postmenopausal. Intervention(s): None. Main Outcome Measure(s): Relative risk of reaching natural menopause at an early age (≤46 years), according to the number of retrieved oocytes at the first IVF attempt. Result(s): Women with a poor response (zero to three oocytes) had a relative risk of 11.6 (95% confidence interval: 3.9-34.7) of having an early menopause as compared with women who have a normal response (> three oocytes). Women who were stimulated with gonadotropins during IVF treatment but did not undergo an IVF puncture because of an anticipated poor response (canceled IVF cycle) had a relative risk of 8.3 (95% confidence interval: 2.9-23.9). Conclusion: These results suggest that women with a low number of retrieved oocytes at the first IVF treatment are more likely to become postmenopausal at an early age than women with a higher number of retrieved oocytes. Our study is the first longitudinal study to provide strong evidence for the quantitative aspect of the ovarian concept of reproductive aging.

Epidemiology, Infertility, IVF treatment, Menopause (age at natural), Retrieved oocytes
dx.doi.org/10.1016/S0015-0282(02)02972-2, hdl.handle.net/1765/64860
Fertility and Sterility
Department of Gynaecology & Obstetrics

de Boer, E.J, den Tonkelaar, I, te Velde, E.R, Burger, C.W, Klip, H, & van Leeuwen, F.E. (2002). A low number of retrieved oocytes at in vitro fertilization treatment is predictive of early menopause. Fertility and Sterility, 77(5), 978–985. doi:10.1016/S0015-0282(02)02972-2