Selcuk Selcuk, Bilgic Bulent Emre, Kilicci Cetin, Kucukbas Mehmet, Cam Cetin, Kutlu Huseyin Tayfun, Karateke Ates
Department of Obstetrics and Gynecology, Zeynep Kamil Maternity and Pediatric Research and Training Hospital, Istanbul, Turkey.
Department of IVF, Zeynep Kamil Maternity and Pediatric Research and Training Hospital, Istanbul, Turkey.
Arch Med Sci. 2018 Jun;14(4):851-859. doi: 10.5114/aoms.2016.62447. Epub 2016 Sep 22.
This study aims to compare the association between the most commonly used ovarian responsiveness markers - age, anti-Müllerian hormone levels (AMH), antral follicle count (AFC), ovarian sensitivity index (OSI), and ovarian response prediction index (ORPI) - and ovarian responsiveness to gonadotropin stimulation in assisted reproductive technology (ART) cycles.
Patients who underwent intracytoplasmic sperm injection treatment using either a gonadotropin releasing hormone (GnRH) antagonist or agonist protocol were enrolled in the study. Data of the patients were abstracted from the hospital's database. Tests were compared for total number of retrieved oocytes, metaphase II (MII) oocytes, embryos, good quality embryos on day 1 and day 3, and ongoing pregnancies per cycle.
The OSI was the ovarian response test that had the strongest relationship with the ART outcomes. The level of association between the ovarian response tests and poor ovarian response data was (in descending order): OSI, ORPI, AFC, AMH, and age (AUC = 0.976, AUC = 0.905, AUC = 0.899, AUC = 0.864, AUC = 0.617). The overall association between OSI and poor ovarian response was significantly higher than the other parameters ( = 0.0023, = 0.0014, = 0.0001, ≤ 0.0001). In patients with high ovarian response data, OSI had the highest association, followed by AFC and ORPI age (AUC = 0.984, AUC = 0.907, AUC = 0.887). There was no statistically significant difference among the tests for the data of patients with ongoing pregnancies.
In this study, which is the first study comparing the five most frequently used ovarian responsiveness markers and the second study signifying the role of OSI in an antagonist protocol, OSI was found to be more convenient to calculate, and it could be superior to other ovarian responsiveness markers for poor and high ovarian responses on cycles with agonist or antagonist protocols.
本研究旨在比较辅助生殖技术（ART）周期中最常用的卵巢反应性标志物——年龄、抗苗勒管激素水平（AMH）、窦卵泡计数（AFC）、卵巢敏感性指数（OSI）和卵巢反应预测指数（ORPI）——与促性腺激素刺激下卵巢反应性之间的关联。
纳入采用促性腺激素释放激素（GnRH）拮抗剂或激动剂方案进行卵胞浆内单精子注射治疗的患者。患者数据从医院数据库中提取。比较各项检测指标的获卵总数、成熟（MII）卵母细胞数、胚胎数、第1天和第3天的优质胚胎数以及每个周期的持续妊娠情况。
OSI是与ART结局关系最密切的卵巢反应性检测指标。卵巢反应性检测指标与卵巢低反应数据之间的关联程度（降序排列）为：OSI、ORPI、AFC、AMH和年龄（曲线下面积[AUC]=0.976、AUC=0.905、AUC=0.899、AUC=0.864、AUC=0.617）。OSI与卵巢低反应之间的总体关联显著高于其他参数（P=0.0023、P=0.0014、P=0.0001、P≤0.0001）。在卵巢高反应数据的患者中，OSI的关联性最高，其次是AFC和ORPI年龄（AUC=0.984、AUC=0.907、AUC=0.887）。对于持续妊娠患者的数据，各项检测指标之间无统计学显著差异。
本研究是比较五种最常用卵巢反应性标志物的首项研究，也是表明OSI在拮抗剂方案中作用的第二项研究，研究发现OSI计算更简便，在激动剂或拮抗剂方案周期中，对于卵巢低反应和高反应情况，它可能优于其他卵巢反应性标志物。
