Yadav Vikas, Malhotra Neena, Mahey Reeta, Singh Neeta, Kriplani Alka
-Department of Obstetrics and Gynecology, AIIMS, New Delhi, India.
J Reprod Infertil. 2019 Apr-Jun;20(2):83-88.
In this study, an attempt was made to validate the use of OSI as a measure of ovarian response during IVF treatment and to correlate OSI with age and BMI and other measures of ovarian response such as AMH, antral follicle count (AFC), total dose of administered gonadotrophins, and duration of stimulation.
This study was a retrospective comparative cohort one. The study included a total of 2150 women who underwent the first IVF cycle between January 2008 and December 2017 at our center using long-agonist protocol. Patients were divided into four subgroups according to the circulating AMH level: below the 25th percentile (AMH 0.25-1.1 , subgroup A), between 25th and 50th percentiles (AMH 1.2-1.6 , subgroup B), between the 50th and 75th percentiles (AMH1.7-2.6 , subgroup C), and above the 75th percentile (AMH 2.7-8.5 , subgroup D). Qualitative data were analyzed by Chi-square or Fisher's exact test. The p<0.05 was considered statistically significant.
The four subgroups formed on the basis of the AMH level did not significantly differ for age, BMI and infertility duration. OSI was significantly correlated to age (r=0.167; p=0.001), and has negative correlation with AFC (r=-0.236, p=0.001) and AMH levels (r=-0.123, p=0.001). Multiple linear regression analysis was done on OSI with other independent variables such as age, BMI, AFC, AMH. Analysis showed that approximately 8% variation in the value of OSI can be attributed to these variables with the highest correlation with antral follicle count.
The present study showed that OSI appears to be a highly reliable index of ovarian responsiveness to recombinant FSH and can be useful to estimate the FSH dose.
在本研究中，试图验证卵巢刺激指数（OSI）作为体外受精（IVF）治疗期间卵巢反应指标的用途，并将OSI与年龄、体重指数（BMI）以及其他卵巢反应指标（如抗缪勒管激素（AMH）、窦卵泡计数（AFC）、促性腺激素给药总量和刺激持续时间）进行关联。
本研究为一项回顾性比较队列研究。该研究共纳入2150名于2008年1月至2017年12月在本中心采用长效激动剂方案进行首次IVF周期治疗的女性。根据循环AMH水平将患者分为四个亚组：低于第25百分位数（AMH 0.25 - 1.1，A亚组）、第25至50百分位数之间（AMH 1.2 - 1.6，B亚组）、第50至75百分位数之间（AMH 1.7 - 2.6，C亚组）以及高于第75百分位数（AMH 2.7 - 8.5，D亚组）。定性数据采用卡方检验或费舍尔精确检验进行分析。p<0.05被认为具有统计学意义。
基于AMH水平形成的四个亚组在年龄、BMI和不孕持续时间方面无显著差异。OSI与年龄显著相关（r = 0.167；p = 0.001），与AFC呈负相关（r = -0.236，p = 0.001），与AMH水平呈负相关（r = -0.123，p = 0.001）。对OSI与年龄、BMI、AFC、AMH等其他自变量进行多元线性回归分析。分析表明，OSI值中约8%的变异可归因于这些变量，其中与窦卵泡计数的相关性最高。
本研究表明，OSI似乎是卵巢对重组促卵泡激素反应性的高度可靠指标，可用于估计促卵泡激素剂量。
