Reproductive outcomes in women with low ovarian reserve

Karunakaran, Bala Muruhan (2019). Reproductive outcomes in women with low ovarian reserve. University of Birmingham. Ph.D.

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Abstract

The number of women with low ovarian reserve seeking fertility treatment is increasing, due to advancing maternal age at conception. Women with low ovarian reserve have a low IVF success rate. This thesis aims to increase our understanding of women with low ovarian reserve, their reproductive outcomes and their reproductive physiology. The evidence is synthesised using two systematic reviews, a prospective cohort study, a retrospective analysis of data and two qualitative studies. The main findings are:

1. Low ovarian reserve, quantified by AFC, AMH and FSH, is associated with low live birth rates and incidences of pregnancy loss after assisted reproduction.
2. There is inter-cycle variation in AFC, AMH and FSH in women. In this cohort, FSH and AFC appear to have a higher magnitude of variation in comparison to AMH.
3. There is inter-cycle variation in AFC, AMH and FSH in women with low ovarian reserve.
4. Clinicians find treating women with low ovarian reserve challenging. Women with low ovarian reserve are unaware of their low IVF success rates and there is cultural and religious stigma about the acceptance of egg donation. Both clinicians and women with low ovarian reserve express willingness to take part and support research studies.

Type of Work:

Thesis (Doctorates > Ph.D.)

Award Type:

Doctorates > Ph.D.

Supervisor(s):