Predictive percent decrease in the expected metaphase II oocytes with increasing age among infertile women undergoing intracytoplasmic sperm injection.

Abstract

Objective: This study aimed to determine which variables primarily influence the number of expected mature oocytes (MII) and to establish the expected percent decrease in the number of MII oocytes retrieved in infertile patients undergoing ICSI. Materials and Methods: In this retrospective cross-sectional study, we included infertile women aged 23 to 44 years who underwent intracytoplasmic sperm injection between January 2013 and November 2017 at an assisted reproduction center in Guayaquil, Ecuador. The study variables included patient age, infertility diagnosis, ovarian stimulation protocol, number of aspirated follicles, number of recovered oocytes, and number of MII-stage oocytes. Ethical approval was obtained from the director of the reproductive medicine clinic for handling patient medical records, and inclusion and exclusion criteria were rigorously applied. A Poisson regression model was utilized to predict the decrease in the proportion of expected MII oocytes retrieved annually with increasing age. Results: The medical records of 244 infertile women were analyzed. There were marked differences in the number of oocytes retrieved and MII oocytes retrieved, particularly in women with ovarian insufficiency and those aged >40 years. The Poisson regression model predicted that the proportion of expected MII oocytes would decrease by 3.99% each year as the patient's age increased. Other variables in the model did not significantly predict the decrease in MII oocyte proportions. 2 Conclusion: This study's findings suggest a 3.99% annual decrease in the proportion of expected MII oocytes with increasing age among infertile women undergoing ICSI. These results underscore the importance of age-specific strategies in infertility treatment to optimize outcomes, particularly for women of advanced maternal age.