A low number of retrieved oocytes at in vitro fertilization treatment is predictive of early menopause

Fertil Steril. 2002 May;77(5):978-85. doi: 10.1016/s0015-0282(02)02972-2.


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.

MeSH terms

  • Adult
  • Aging*
  • Case-Control Studies
  • Cell Count
  • Cohort Studies
  • Female
  • Fertilization in Vitro*
  • Humans
  • Menopause*
  • Oocytes / cytology*
  • Ovulation Induction
  • Prognosis
  • Risk
  • Tissue and Organ Harvesting*
  • Treatment Failure