Observational Study on Effect of Age on Number of Oocyte Retrieval when Human Menopausal Gonadotropins is being given in Women Undergoing IVF


Authors : Prem Patel

Volume/Issue : Volume 10 - 2025, Issue 1 - January


Google Scholar : https://tinyurl.com/y3m8ae2h

Scribd : https://tinyurl.com/6vwv65df

DOI : https://doi.org/10.5281/zenodo.14709616


Abstract : Assisted reproductive technologies, specifically in vitro fertilization (IVF), have revolutionized fertility treatments, offering hope to couples facing challenges in conceiving naturally. Within the context of IVF, Human Menopausal Gonadotropin (hMG) plays a crucial role in ovarian stimulation, promoting the development of multiple follicles and increasing the likelihood of successful oocyte retrieval. However, the impact of age on the ovarian response to hMG stimulation is well- documented, with aging women often exhibiting altered patterns of follicular growth and hormonal dynamics. Advanced maternal age is associated with a decline in ovarian reserve and diminished oocyte quality, potentially influencing the outcomes of IVF cycles. This study aims to fill this knowledge gap by meticulously investigating how age influences ovarian response during IVF cycles with hMG, providing valuable insights to inform personalized and optimized fertility treatment protocols for women across different age groups. Retrospective analysis of 113 women aged 26-45 undergoing IVF with hMG at selected site in period of 3 months. Extracting relevant data from patient records, including age, baseline hormones, stimulation details, AFC count, and oocyte retrieval. The obtained data was analysed by descriptive analysis (ANOVA) using Ms excel. An overview of the oocyte yield for every age group may be seen in the average total oocyte count. According to the data, the mean number gradually decreases with age, which is consistent with aging-related decreases in follicular response and ovarian reserve. The study shows that the 26-30 age group had the highest number of oocytes while oocyte Numbers in the age groups of 31–35, 36–40, and 41–45 indicate a consistent age-related drop in the total oocyte retrieval count. This reduction occurs as a result of aging-related declines in ovarian reserve and follicular quality, which lessen the ovarian response to stimulation during IVF treatment.

Keywords : IVF, Human Menopausal Gonadotropin (hMG), Oocyte, Age, AFC, Infertility.

References :

  1. Singh K, Dewani D. Recent Advancements in In Vitro Fertilisation. Cureus. 2022 Oct 10;14(10):e30116.
  2. Wang J, Sauer MV. In vitro fertilization (IVF): a review of 3 decades of clinical innovation and technological advancement. Ther Clin Risk Manag. 2006 Dec;2(4):355-64.
  3. Broekmans FJ, Soules MR, Fauser BC. Ovarian aging: mechanisms and clinical consequences. Endocr Rev. 2009 Aug;30(5):465-93.
  4. Devroey P, Polyzos NP, Blockeel C. An OHSS-Free Clinic by segmentation of IVF treatment. Hum Reprod. 2011 Oct;26(10):2593-7.
  5. te Velde ER, Pearson PL. The variability of female reproductive ageing. Hum Reprod Update. 2002 Mar-Apr;8(2):141-54.
  6. Sunkara SK, Rittenberg V, Raine-Fenning N, Bhattacharya S, Zamora J, Coomarasamy A. Association between the number of eggs and live birth in IVF treatment: an analysis of 400 135 treatment cycles. Hum Reprod. 2011 Jul;26(7):1768-74.
  7. Broekmans FJ, Kwee J, Hendriks DJ, Mol BW, Lambalk CB. A systematic review of tests predicting ovarian reserve and IVF outcome. Hum Reprod Update. 2006 Nov-Dec;12(6):685-718.
  8. Himabindu Y, Sriharibabu M, Gopinathan K, Satish U, Louis TF, Gopinath P. Anti-mullerian hormone and antral follicle count as predictors of ovarian response in assisted reproduction. J Hum Reprod Sci. 2013 Jan;6(1):27-31.
  9. Practice Committee of American Society for Reproductive Medicine. Ovarian hyperstimulation syndrome. Fertil Steril. 2008 Nov;90(5 Suppl):S188-93.
  10. Deshpande PS, Gupta AS. Causes and Prevalence of Factors Causing Infertility in a Public Health Facility. J Hum Reprod Sci. 2019 Oct-Dec;12(4):287-293.
  11. Paulson RJ. Introduction: Contemporary approaches to alternative ovarian stimulation strategies for in vitro fertilization. Fertil Steril. 2017 Oct;108(4):555-557.
  12. Cimadomo D, Fabozzi G, Vaiarelli A, Ubaldi N, Ubaldi FM, Rienzi L. Impact of Maternal Age on Oocyte and Embryo Competence. Front Endocrinol (Lausanne). 2018 Jun 29;9:327.
  13. Nazemian Z, Esfandiari N, Javed M, Casper RF. The effect of age on in vitro fertilization outcome: is too young possible? J Assist Reprod Genet. 2011 Feb;28(2):101-6.
  14. Zhouxuan Li, Songyuan Tang, Shan Liu, Huan Xu, Zhen Lei, Ying Zhong. Effect of Female Age on Infertility Diagnostic Factors and In-vitro Fertilization Treatment Outcomes: A Single-center Retrospective Cohort Study. medRxiv 2021.01.04.21249246
  15. Yan J, Wu K, Tang R, Ding L, Chen ZJ. Effect of maternal age on the outcomes of in vitro fertilization and embryo transfer (IVF-ET). Sci China Life Sci. 2012 Aug;55(8):694-8.
  16. Devesa M, Tur R, Rodríguez I, Coroleu B, Martínez F, Polyzos NP. Cumulative live birth rates and number of oocytes retrieved in women of advanced age. A single centre analysis including 4500 women ≥38 years old. Hum Reprod. 2018 Nov 1;33(11):2010-2017.
  17. Sun, YF., Zhang, J., Xu, YM. et al. Effects of age on pregnancy outcomes in patients with simple tubal factor infertility receiving frozen-thawed embryo transfer. Sci Rep 10, 18121 (2020).
  18. Cari Nicholas, Sarah Darmon, Pasquale Patrizio, David F. Albertini, David H. Barad, Norbert Gleicher, Changing clinical significance of oocyte maturity grades with advancing female age advances precision medicine in IVF, iScience, Volume 26, Issue 8, 2023, 107308, ISSN 2589-0042.
  19. Loy SL, Cheung YB, Fortier MV, Ong CL, Tan HH, Nadarajah S, Chan JKY, Viardot-Foucault V. Age-related nomograms for antral follicle count and anti-Mullerian hormone for subfertile Chinese women in Singapore. PLoS One. 2017 Dec 14;12(12):e0189830.
  20. Antonio La Marca, Elena Spada, Giovanna Sighinolfi, Cindy Argento, Alessandra Tirelli, Simone Giulini, Silvano Milani, Annibale Volpe, Age-specific nomogram for the decline in antral follicle count throughout the reproductive period, Fertility and Sterility, Volume 95, Issue 2, 2011, Pages 684-688, ISSN 0015-0282.
  21. Rosen MP, Sternfeld B, Schuh-Huerta SM, Reijo Pera RA, McCulloch CE, Cedars MI. Antral follicle count: absence of significant midlife decline. Fertil Steril. 2010 Nov;94(6):2182-5.
  22. Stamatina Iliodromiti, Carlos Iglesias Sanchez, Claudia-Martina Messow, Maria Cruz, Juan Garcia Velasco, Scott M. Nelson, Excessive Age-Related Decline in Functional Ovarian Reserve in Infertile Women: Prospective Cohort of 15,500 Women, The Journal of Clinical Endocrinology & Metabolism, Volume 101, Issue 9, 1 September 2016, Pages 3548–3554.
  23. Liao S, Xiong J, Tu H, Hu C, Pan W, Geng Y, Pan W, Lu T, Jin L. Prediction of in vitro fertilization outcome at different antral follicle count thresholds combined with female age, female cause of infertility, and ovarian response in a prospective cohort of 8269 women. Medicine (Baltimore). 2019 Oct;98(41):e17470.
  24. David Tolulope Ejenobo, Nkeiruka Ameh, Joseph A. M. Otubu, Bolarinde Ola, Ibrahim Wada, Augustine Monday Onuh, Prediction of Poor Ovarian Response during In vitro  Fertilization in Nigerian Women: A Comparison of Basal Antral Follicle Count and Follicle‑Stimulating Hormone, Nigerian Journal of Medicine, Apr 14, 2023, Vol. 31 No. 6 (2022).
  25. Anik ilhan g, erkanli senturk g, oktem o, durmusoglu f. The impact of hmg on follicular fluid hormone levels, embryo quality and ivf outcome. Eastern journal of medicine. April 2014;19(1):22-27.
  26. Felberbaum RE, Albano C, Ludwig M, Riethmüller-Winzen H, Grigat M, Devroey P, Diedrich K. Ovarian stimulation for assisted reproduction with HMG and concomitant midcycle administration of the GnRH antagonist cetrorelix according to the multiple dose protocol: a prospective uncontrolled phase III study. Hum Reprod. 2000 May;15(5):1015-20.
  27. Hua R, Ma L, Li H. Clinical effects of a natural extract of urinary human menopausal gonadotrophin in normogonadotropic infertile patients. Int J Reprod Med. 2013;2013:135258.
  28. Li HQ, Pan XL, Su NJ, Lu XP, Chen JQ, Chen XW. Retrospective analysis: The application of human menopausal gonadotropin combined with letrozole for IUI in patients undergoing artificial insemination by husband due to unexplained or mild male factors. Front Endocrinol (Lausanne). 2022 Dec 20;13:1038433.
  29. Shi S, Hong T, Jiang F, Zhuang Y, Chen L, Huang X. Letrozole and human menopausal gonadotropin for ovulation induction in clomiphene resistance polycystic ovary syndrome patients: A randomized controlled study. Medicine (Baltimore). 2020 Jan;99(4):e18383.
  30. Dai X, Li J, Fu T, Long X, Li X, Weng R, Liu Y, Zhang L. Ovulation induction using sequential letrozole/gonadotrophin in infertile women with PCOS: a randomized controlled trial. Reprod Biomed Online. 2023 Feb;46(2):352-361.
  31. Santos, Margarida Avo, Ewart W Kuijk, and Nick S Macklon. "The impact of ovarian stimulation for IVF on the developing embryo", REPRODUCTION 139, 1 (2010): 23-34, accessed Feb 2, 2024,
  32. Sun B, Ma Y, Li L, Hu L, Wang F, Zhang Y, Dai S, Sun Y. Factors Associated with Ovarian Hyperstimulation Syndrome (OHSS) Severity in Women With Polycystic Ovary Syndrome Undergoing IVF/ICSI. Front Endocrinol (Lausanne). 2021 Jan 19;11:615957.
  33. Kundu S, Ali B, Dhillon P. Surging trends of infertility and its behavioural determinants in India. PLoS One. 2023 Jul 25;18(7):e0289096.
  34. Katole A, Saoji AV. Prevalence of Primary Infertility and its Associated Risk Factors in Urban Population of Central India: A Community-Based Cross-Sectional Study. Indian J Community Med. 2019 Oct-Dec;44(4):337-341.
  35. Broekmans FJ, Soules MR, Fauser BC. Ovarian aging: mechanisms and clinical consequences. Endocr Rev. 2009 Aug;30(5):465-93.
  36. Devroey P, Polyzos NP, Blockeel C. An OHSS-Free Clinic by segmentation of IVF treatment. Hum Reprod. 2011 Oct;26(10):2593-7.
  37. Te Velde ER, Pearson PL. The variability of female reproductive ageing. Hum Reprod Update. 2002 Mar-Apr;8(2):141-54.
  38. Sunkara SK, Rittenberg V, Raine-Fenning N, Bhattacharya S, Zamora J, Coomarasamy A. Association between the number of eggs and live birth in IVF treatment: an analysis of 400 135 treatment cycles. Hum Reprod. 2011 Jul;26(7):1768-74.
  39. Broekmans FJ, Kwee J, Hendriks DJ, Mol BW, Lambalk CB. A systematic review of tests predicting ovarian reserve and IVF outcome. Hum Reprod Update. 2006 Nov-Dec;12(6):685-718.

Assisted reproductive technologies, specifically in vitro fertilization (IVF), have revolutionized fertility treatments, offering hope to couples facing challenges in conceiving naturally. Within the context of IVF, Human Menopausal Gonadotropin (hMG) plays a crucial role in ovarian stimulation, promoting the development of multiple follicles and increasing the likelihood of successful oocyte retrieval. However, the impact of age on the ovarian response to hMG stimulation is well- documented, with aging women often exhibiting altered patterns of follicular growth and hormonal dynamics. Advanced maternal age is associated with a decline in ovarian reserve and diminished oocyte quality, potentially influencing the outcomes of IVF cycles. This study aims to fill this knowledge gap by meticulously investigating how age influences ovarian response during IVF cycles with hMG, providing valuable insights to inform personalized and optimized fertility treatment protocols for women across different age groups. Retrospective analysis of 113 women aged 26-45 undergoing IVF with hMG at selected site in period of 3 months. Extracting relevant data from patient records, including age, baseline hormones, stimulation details, AFC count, and oocyte retrieval. The obtained data was analysed by descriptive analysis (ANOVA) using Ms excel. An overview of the oocyte yield for every age group may be seen in the average total oocyte count. According to the data, the mean number gradually decreases with age, which is consistent with aging-related decreases in follicular response and ovarian reserve. The study shows that the 26-30 age group had the highest number of oocytes while oocyte Numbers in the age groups of 31–35, 36–40, and 41–45 indicate a consistent age-related drop in the total oocyte retrieval count. This reduction occurs as a result of aging-related declines in ovarian reserve and follicular quality, which lessen the ovarian response to stimulation during IVF treatment.

Keywords : IVF, Human Menopausal Gonadotropin (hMG), Oocyte, Age, AFC, Infertility.

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