Evaluation of intracytoplasmic sperm injection Oosit outcomes in patients with single oocyte retrieval

Objective: To evaluate the ICSI outcomes in poor ovarian responders who had only one oocyte retrieved after controlled ovarian hyperstimulation (COH), aiming to guide strategies to improve success rates in this process. Materials and Methods: Patients who underwent ICSI following COH and had only one oocyte retrieved at the Akdeniz University Faculty of Medicine, Department of Obstetrics and Gynecology, Assisted Reproductive Treatment Center between November 2017 and March 2024 were retrospectively reviewed and included in the study. Cycles where oocyte cryopreservation was performed were excluded from the study. General patient information, COH treatment details, oocyte and embryo data, and ICSI outcomes, including transfer and pregnancy results, were accessed through treatment files and electronic databases. Patients were divided into three age groups: <35 years, ≥35-<40 years, and ≥40 years, and the data were analyzed accordingly. Results: MII oocytes were detected in 206 (73.3%) of the 281 cycles where only one oocyte was retrieved. Normal fertilization (2PN) occurred in 59.2% of the ICSI procedures performed. Out of 90 embryos obtained, 65 were transferred, resulting in clinical pregnancy in 12.3% and live birth in 4.6% of cases. The ICSI outcomes for the <35 years, ≥35-<40 years, and ≥40 years age groups were as follows: MII oocyte rates were 73%, 75%, and 72%, normal fertilization rates were 61%, 66%, and 53%, clinical pregnancy rates per embryo transfer were 30%, 15%, and 3%, and live birth rates per embryo transfer were 10%, 4%, and 3%, respectively. No statistically significant differences were found when ICSI outcomes were analyzed across age groups. Conclusion: In women with only one oocyte retrieved following COH and undergoing ICSI, an increase in age was associated with a decline in clinical pregnancy and live birth rates per embryo transfer. However, no statistically significant differences were detected when outcomes were analyzed across age groups. This highlights the importance of providing good counseling services to this patient group, which is underrepresented in the literature. There is a need for larger, more comprehensive prospective studies including a greater number of patients. Keywords: Single oocyte retrieval, poor responders, age groups, ICSI outcomes, clinical pregnancy rate, live birth rate