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超重和血清总胆固醇水平高是 PCOS 患者 IVF/ICSI 周期结局的危险因素,建立了一种针对 PCOS 患者活产率的预测模型。

Overweight and high serum total cholesterol were risk factors for the outcome of IVF/ICSI cycles in PCOS patients and a PCOS-specific predictive model of live birth rate was established.

机构信息

Reproductive Medicine Center, The Sixth Affiliate Hospital of Sun Yat-sen University, Guangzhou, 510655, China.

Department of Andrology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510000, China.

出版信息

J Endocrinol Invest. 2020 Sep;43(9):1221-1228. doi: 10.1007/s40618-020-01209-5. Epub 2020 Mar 27.

DOI:10.1007/s40618-020-01209-5
PMID:32221909
Abstract

PURPOSE

The clinical outcome after in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) is diverse in infertility patients with polycystic ovary syndrome (PCOS). The aim of this study was to develop a nomogram based on an association of patients' characteristics to predict the live birth rate in PCOS patients.

METHODS

All women in a public university hospital who attempted to conceive by IVF/ICSI for PCOS infertility from January 2014 to October 2018 were included. The nomogram was built from a training cohort of 178 consecutive patients and tested on an independent validation cohort of 81 patients. PCOS was confirmed in all participants.

RESULTS

Three variates significantly associated with live birth rate of PCOS patients were BMI, total serum cholesterol (TC) and basal FSH. This predictive model built on the basis of BMI, TC, basal FSH, type of embryo transferred and age showed good calibration and discriminatory abilities, with an area under the curve (AUC) of 0.708 (95% CI 0.632-0.785) for the training cohort. The nomogram showed satisfactory goodness-of-fit and discrimination abilities in the independent validation cohort, with an AUC of 0.686 (95% CI 0.556-0.815).

CONCLUSION

Our simple evidence-based nomogram presents graphically risk factors and prognostic models for IVF/ICSI outcomes in patients with PCOS, which can offer useful guidance to clinicians and patients for individual adjuvant therapy.

摘要

目的

患有多囊卵巢综合征(PCOS)的不孕患者在接受体外受精(IVF)或胞浆内单精子注射(ICSI)后的临床结局存在差异。本研究旨在基于患者特征的关联建立一个列线图,以预测 PCOS 患者的活产率。

方法

本研究纳入了 2014 年 1 月至 2018 年 10 月在一所公立大学医院因 PCOS 不孕而接受 IVF/ICSI 治疗的所有女性。该列线图由 178 例连续患者的训练队列构建,并在 81 例独立验证队列中进行了测试。所有参与者均确诊为 PCOS。

结果

有 3 个变量与 PCOS 患者的活产率显著相关,分别是 BMI、总胆固醇(TC)和基础 FSH。该预测模型基于 BMI、TC、基础 FSH、移植胚胎类型和年龄建立,在训练队列中的曲线下面积(AUC)为 0.708(95%CI 0.632-0.785),具有良好的校准和区分能力。在独立验证队列中,该列线图也表现出良好的拟合优度和区分能力,AUC 为 0.686(95%CI 0.556-0.815)。

结论

我们的简单基于证据的列线图以图形方式呈现了 PCOS 患者接受 IVF/ICSI 治疗后的风险因素和预后模型,可为临床医生和患者提供有用的指导,以便进行个体化辅助治疗。

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