Objective: To investigate whether follicular phase characteristics associated with ovarian aging can be observed in women of normal reproductive age, who had previously shown a poor response to ovarian hyperstimulation for IVF. Design: Observational, prospective study. Setting: Tertiary fertility center. Patient(s): Eleven regularly cycling, ovulatory women, aged 29-40 years who previously presented with fewer than four dominant follicles after ovarian hyperstimulation for IVF. Intervention(s): Frequent serum hormone assessments and transvaginal ultrasound during the follicular phase of a spontaneous, unstimulated cycle. Main Outcome Measure(s): Duration of the follicular phase; serum LH, FSH, E2, P, inhibin A, and inhibin B levels; and number of antral follicles observed by ultrasound. Results were compared with the cycle characteristics of a reference population of 38 healthy normo-ovulatory women aged 20-36 years (as published elsewhere). Result(s): Poor responders had significantly fewer antral follicles than controls. Median FSH concentrations were significantly higher compared with controls, but the majority had FSH levels within the normal range. Follicular phase P levels were significantly higher in poor responders. Duration of the follicular phase, E2, and inhibin A and inhibin B serum levels did not differ between poor responders and controls. Conclusion(s): Normo-ovulatory regularly cycling women with a previous poor response to ovarian hyperstimulation for IVF show follicular phase characteristics suggestive of ovarian aging.

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doi.org/10.1016/S0015-0282(02)03227-2, hdl.handle.net/1765/66699
Fertility and Sterility
Department of Gynaecology & Obstetrics

Beckers, N.G.M, Macklon, N.S, Eijkemans, M.J.C, & Fauser, B.C.J.M. (2002). Women with regular menstrual cycles and a poor response to ovarian hyperstimulation for in vitro fertilization exhibit follicular phase characteristics suggestive of ovarian aging. Fertility and Sterility, 78(2), 291–297. doi:10.1016/S0015-0282(02)03227-2