Amaç: Azalmış over rezervi (DOR) infertilite tedavisinde önemli bir zorluk teşkil etmektedir. Anti-Müllerian hormon (AMH) over rezervinin önemli bir göstergesidir ve yardımcı üreme teknolojilerinde (YÜT) canlı doğum sonuçlarıyla ilişkilendirilmiştir. Bu çalışmanın amacı, DOR hastalarında canlı doğum (LB) oranlarını en çok etkileyen faktörleri değerlendirmektir. Gereç ve Yöntemler: Bu retrospektif kohort çalışmasına 2020- 2023 yılları arasında intrasitoplazmik sperm enjeksiyonu (ICSI) uygulanan 195 DOR hastası dahil edilmiştir. Hastalar “canlı doğum” (n=26) ve “canlı doğum olmayan” (n=169) gruplara ayrılmıştır. Yaş, antral folikül sayısı (AFC), bazal hormon seviyeleri, AMH, alınan oosit sayısı, embriyo kalitesi ve endometriyal kalınlık gibi parametreler tek değişkenli ve çok değişkenli lojistik regresyon kullanılarak analiz edilmiştir. Bu faktörlerin LB sonuçları için öngörücü değerini değerlendirmek için ROC analizi uygulandı. Bulgular: AMH, 0.93 ng/mL kesme değeri ile LB'nin en anlamlı öngörücüsü olarak belirlendi. Yaş, AFC ve endometriyal kalınlık gibi diğer faktörler sınırlı öngörü doğruluğu göstermiştir. Dondurulmuş embriyo transferi (FET) döngüleri, taze embriyo transferlerine kıyasla daha yüksek LB oranları ile anlamlı şekilde ilişkiliydi (OR=4.33, p=0.008). Sonuç: AMH düzeyleri, DOR hastalarında, özellikle POSEIDON 3-4 gruplarında LB'nin önemli bir belirleyicisidir. Bulgular, FET'in daha iyi LB sonuçları ile ilişkili olduğu bireyselleştirilmiş tedavi stratejilerinin kullanımını desteklemektedir.

Objective: Diminished ovarian reserve (DOR) poses a significant challenge in infertility treatment. Anti-Müllerian hormone (AMH) is an important indicator of ovarian reserve and has been linked to live birth outcomes in assisted reproductive technologies (ART). This study aims to evaluate the factors most significantly impacting live birth (LB) rates in patients with DOR. Materials and Methods: This retrospective cohort study included 195 DOR patients undergoing intracytoplasmic sperm injection (ICSI) between 2020 and 2023. Patients were divided into "LB" (n=26) and "non-LB" (n=169) groups. Parameters such as age, antral follicle count (AFC), basal hormone levels, AMH, number of oocytes retrieved, embryo quality, and endometrial thickness were analyzed using univariate and multivariate logistic regression. ROC analysis was applied to assess the predictive value of these factors for LB outcomes. Results: AMH was identified as the most significant predictor of LB, with a cutoff value of 0.93 ng/mL. Other factors such as age, AFC, and endometrial thickness showed limited predictive accuracy. Frozen embryo transfer (FET) cycles were significantly associated with higher LB rates compared to fresh embryo transfers (OR=4.33, p=0.008). Conclusion: AMH levels are a key predictor of LB in DOR patients, particularly in POSEIDON 3-4 groups. The findings support the use of individualized treatment strategies, with FET being associated with improved LB outcomes in this patient population. Further research is needed to optimize ART protocols for patients with DOR.

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