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在体外受精/卵胞浆内单精子注射周期中,使用注射用重组人促卵泡激素α/促性腺激素释放激素拮抗剂方案进行控制性卵巢刺激时卵巢反应的预测因素。

Predictive factors for ovarian response in a corifollitropin alfa/GnRH antagonist protocol for controlled ovarian stimulation in IVF/ICSI cycles.

作者信息

Oehninger Sergio, Nelson Scott M, Verweij Pierre, Stegmann Barbara J

机构信息

The Jones Institute for Reproductive Medicine, Eastern Virginia Medical School, 601 Colley Avenue, Norfolk, VA, 23507-2007, USA.

School of Medicine, University of Glasgow, Glasgow, UK.

出版信息

Reprod Biol Endocrinol. 2015 Oct 31;13:117. doi: 10.1186/s12958-015-0113-1.

Abstract

BACKGROUND

This secondary analysis aimed to identify predictors of low (<6 oocytes retrieved) and high ovarian response (>18 oocytes retrieved) in IVF patients undergoing controlled ovarian stimulation with corifollitropin alfa in a gonadotropin-releasing hormone (GnRH) antagonist protocol.

METHODS

Statistical model building for high and low ovarian response was based on the 150 μg corifollitropin alfa treatment group of the Pursue trial in infertile women aged 35-42 years (n = 694).

RESULTS

Multivariable logistic regression models were constructed in a stepwise fashion (P <0.05 for entry). 14.1 % of subjects were high ovarian responders and 23.2 % were low ovarian responders. The regression model for high ovarian response included four independent predictors: higher anti-Müllerian hormone (AMH) and antral follicle count (AFC) increased the risk, and higher follicle-stimulating hormone (FSH) levels and advancing age decreased the risk of high ovarian response. The regression model for low ovarian response also included four independent predictors: advancing age increased the risk, and higher AMH, higher AFC and longer menstrual cycle length decreased the risk of low ovarian response.

CONCLUSIONS

AMH, AFC and age predicted both high and low ovarian responses, FSH predicted high ovarian response, and menstrual cycle length predicted low ovarian response in a corifollitropin alfa/GnRH antagonist protocol.

TRIAL REGISTRATION NUMBER

NCT01144416 , Protocol P06029.

摘要

背景

本二次分析旨在确定在接受促性腺激素释放激素(GnRH)拮抗剂方案、使用阿法链促卵泡素进行控制性卵巢刺激的体外受精(IVF)患者中,低卵巢反应(获卵数<6个)和高卵巢反应(获卵数>18个)的预测因素。

方法

高、低卵巢反应的统计模型构建基于Pursue试验中年龄在35 - 42岁的不育女性150μg阿法链促卵泡素治疗组(n = 694)。

结果

多变量逻辑回归模型以逐步方式构建(纳入标准为P < 0.05)。14.1%的受试者为高卵巢反应者,23.2%为低卵巢反应者。高卵巢反应的回归模型包括四个独立预测因素:较高的抗苗勒管激素(AMH)和窦卵泡计数(AFC)增加风险,而较高的促卵泡激素(FSH)水平和年龄增长降低高卵巢反应风险。低卵巢反应的回归模型也包括四个独立预测因素:年龄增长增加风险,而较高的AMH、较高的AFC和较长的月经周期长度降低低卵巢反应风险。

结论

在阿法链促卵泡素/GnRH拮抗剂方案中,AMH、AFC和年龄可预测高、低卵巢反应,FSH可预测高卵巢反应,月经周期长度可预测低卵巢反应。

试验注册号

NCT0一一44416,方案编号P06029。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b1e/4628292/093209d45aea/12958_2015_113_Fig1_HTML.jpg

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