The effect of age, basal follicle stimulating hormone, luteinising hormone, estradiol levels, antral follicle number and anti müllerian hormone levels on ovarian response, embryo development and pregnancy outcomes in patients undergoing IVF-ICS/ET with unexplained infertility

The Effect of Age, Basal Follicle Stimulating Hormone, Luteinising Hormone, Estradiol Levels, Antral Follicle Number and Anti Müllerian Hormone Levels on Ovarian Response, Embryo Development and Pregnancy Outcomes in Patients Undergoing IVF-ICS/ET with Unexplained Infertility Objective: In this study, patients diagnosed with unexplained infertility who applied to our IVF clinic between 2018 and 2023 were analysed. We aimed to analyse the effect of demographic characteristics, hormone profiles and number of antral follicles on ovarian response, embryogenesis and pregnancy outcomes. Materials and Methods: 313 patients with unexplained infertility who applied to Çukurova University Faculty of Medicine, Gynaecology and Obstetrics IVF outpatient clinic between 2018-2023 were retrospectively analysed. Results: The study included 313 patients with unexplained infertility. There was a statistically low level negative correlation between the age of the patients and the number of oocytes collected, the number of oocytes at metaphase 2 stage and the number of embryos formed. (p<0,05) There was a statistically low level negative correlation between the body mass index of the patients and the number of oocytes collected, the number of oocytes at metaphase 2 stage and the number of embryos formed. (p<0,05) There was a statistically low level negative correlation between FSH level and number of oocytes collected, number of oocytes at metaphase 2 stage and number of embryos formed. (p<0,05) There was a statistically low level negative correlation between the FSH/LH ratio and the number of oocytes collected, the number of oocytes at metaphase 2 stage and the number of embryos formed. (p<0,05) There was a statistically low level positive correlation between the AMH level and the number of oocytes collected, the number of oocytes at metaphase 2 stage and the number of embryos formed. (p<0,05) There was a statistically high positive correlation between the AFC count and the number of oocytes collected, the number of oocytes at metaphase 2 stage and the number of embryos formed. (p<0,05) There was a statistically significant difference between the E2 level of the patients and the groups with and without beta hcg positivity.(p<0,05) There was a statistically significant difference between the AFC count of the patients and the groups with and without beta hcg positivity.(p<0,05) . Frozen embryo transfer (n:10) patients were included in the study. . GnRH agonist treatment protocol was applied to (n:92) and GnRH antagonist treatment protocol was applied to (n:163) of the patients. Cycle cancellation was observed in 4 patients. There was no statistically significant difference between the treatment protocol and beta hcg positivity. Conclusion: Age, body mass index and number of antral follicles are associated with ovarian response and pregnancy outcomes. Basal FSH and AMH are associated with ovarian response. Basal estradiol is associated with pregnancy outcomes. The diagnosis of unexplained infertility is still used as a diagnosis of exclusion. More randomised controlled trials are needed to understand the etiology and mechanism. Keywords: Unexplained infertility, Age, AMH, IVF, FSH