Abstract
<title>Abstract</title> <p>Purpose To determine reproductive outcomes in a low-oocyte-yield population and identify the factors independently associated with live birth. Methods Retrospective single center study including all oocyte retrievals performed between January 2010 and December 2023. Cycles retrieving one to three oocytes were analyzed. Clinical pregnancy, cumulative live birth and miscarriage rates were assessed. Multivariable logistic regression identified independent predictors of live birth and abortion. Results Of 29,217 oocyte retrievals, 3,761 (12.9%) yielded one to three oocytes (538 with one, 1,361 with two, 1,862 with three). Cumulative live birth rate per retrieval increased progressively with oocyte number (4.46%, 9.04% and 12.67% respectively; p < 0.001). In multivariable analysis, retrieval of two (adjusted odds ratio [aOR] 1.99, 95% CI 1.23—3.25; p = 0.005) or three oocytes (aOR 2.63, 95% CI 1.65–4.19; p < 0.001) remained independently associated with live birth. Maternal age > 37 years significantly reduced live birth probability (aOR 0.40, p < 0.001) and increased miscarriage risk (aOR 3.3; p < 0.001). Oocyte number was not associated with miscarriage. Conclusions In ART cycles retrieving 1–3 oocytes, live birth probability increases with each additional oocyte, whereas miscarriage risk is predominantly age-dependent. Low oocyte yield does not preclude clinically meaningful success, but maternal age remains the principal determinant of reproductive outcome. These findings provide evidence-based counselling data for women experiencing poor ovarian response. Study funding/competing interest(s): None. The authors report no conflicts of interest. Trial registration number: ClinicalTrials.gov ID NCT06950476, 28th April 2025</p>