Kim Seul Ki, Kim Hyein, Oh Soohyun, Lee Jung Ryeol, Jee Byung Chul, Kim Seok Hyun
Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
Obstet Gynecol Sci. 2018 Nov;61(6):669-674. doi: 10.5468/ogs.2018.61.6.669. Epub 2018 Oct 8.
This study aimed to develop a nomogram that predicts ongoing pregnancy after fertilization and embryo transfer (IVF-ET) using patient age and serum hormonal markers.
A total of 284 IVF-ET cycles were retrospectively analyzed. At 14 days post-oocyte pick-up (OPU), the serum human chorionic gonadotropin (HCG) and progesterone levels were measured. The main predicted outcome was ongoing pregnancy.
Patient age and serum of HCG and progesterone levels at 14 days post-OPU were good predictors of ongoing pregnancy. The cut-off value and area under the curve (AUC) (95% confidence interval) were 36.5 years and 0.666 (0.599-0.733), respectively, for patient age; 67.8 mIU/mL and 0.969 (0.951-0.987), respectively, for serum HCG level; and 29.8 ng/mL and 0.883 (0.840-0.925), respectively, for serum progesterone level. When the prediction model was constructed using these three parameters, the addition of serum progesterone level to the prediction model did not increase its overall predictability. Furthermore, a high linear co-relationship was found between serum HCG and progesterone levels. Therefore, we developed a new nomogram using patient age and HCG serum level only. The AUC of the newly developed nomogram for predicting ongoing pregnancy after IVF-ET cycles using patient age and serum HCG level was as high as 0.975.
We showed that ongoing pregnancy may be predicted using only patient age and HCG serum level. Our nomogram could help clinicians and patients predict ongoing pregnancy after IVF-ET if the serum JCG level was ≥5 IU/L at 14 days post-OPU.
本研究旨在开发一种列线图,利用患者年龄和血清激素标志物预测体外受精-胚胎移植(IVF-ET)后的持续妊娠情况。
对284个IVF-ET周期进行回顾性分析。在取卵后14天,测定血清人绒毛膜促性腺激素(HCG)和孕酮水平。主要预测结果为持续妊娠。
患者年龄以及取卵后14天的血清HCG和孕酮水平是持续妊娠的良好预测指标。患者年龄的截断值和曲线下面积(AUC)(95%置信区间)分别为36.5岁和0.666(0.599 - 0.733);血清HCG水平分别为67.8 mIU/mL和0.969(0.951 - 0.987);血清孕酮水平分别为29.8 ng/mL和0.883(0.840 - 0.925)。当使用这三个参数构建预测模型时,在预测模型中加入血清孕酮水平并未提高其总体预测能力。此外,发现血清HCG和孕酮水平之间存在高度线性共关系。因此,我们仅使用患者年龄和HCG血清水平开发了一种新的列线图。使用患者年龄和血清HCG水平预测IVF-ET周期后持续妊娠的新开发列线图的AUC高达0.975。
我们表明仅使用患者年龄和HCG血清水平即可预测持续妊娠情况。如果取卵后14天血清JCG水平≥5 IU/L,我们的列线图可帮助临床医生和患者预测IVF-ET后的持续妊娠情况。