Age or Ovarian Reserve? A Comparative Study of IVF Outcomes in Young Women with DOR and Older Women with NOR

The aim of this study was to evaluate whether chronological age or ovarian reserve exerts a greater influence on in vitro fertilization (IVF) outcomes. A retrospective cohort analysis was conducted, including 108 women undergoing IVF at In vitro OG Medical Centre Dimitrov between 2018 and 2024. Participants were classified as OLDER NOR (age > 35 years, AMH ≥ 1.5 ng/ml) and YOUNG DOR (age ≤ 35 years, AMH ≤1.1 ng/ml). Although women in the OLDER NOR cohort exhibited higher AMH levels, younger women with diminished ovarian reserve achieved better clinical outcomes – higher fertilization, clinical pregnancy, and live birth rates. These findings suggest that chronological age has a stronger impact on embryo competence and implantation potential than ovarian reserve markers alone, highlighting the predominant role of age in determining reproductive success in IVF cycles.