Kobanawa Masato
Kobanawa Clinic Ibaraki Japan.
Reprod Med Biol. 2023 Jan 20;22(1):e12499. doi: 10.1002/rmb2.12499. eCollection 2023 Jan-Dec.
To create a gonadotropin starting dose calculator for controlled ovarian stimulation, which can adjust the target number of oocytes and stimulation duration for each facility to achieve individualized controlled ovarian stimulation among the Japanese patients.
The patients received controlled ovarian stimulation using the gonadotropin-releasing hormone antagonist protocol, and oocytes were retrieved. Using single regression analysis, we selected age, anti-Müllerian hormone (AMH), and initial serum follicle-stimulating hormone as variables to predict the number of oocytes retrieved per gonadotropin dose (oocyte sensitivity index). Each variable was then analyzed using backward stepwise multiple regression.
Age and AMH were selected as predictive variables from the backward stepwise multiple regression, and we developed a multiple regression equation. We decomposed the equation as the number of oocytes retrieved/(gonadotropin starting dose × stimulation duration days) and created a calculation formula to predict the gonadotropin starting dose from the target number of oocytes and stimulation duration days.
This is the first study to develop an individualized dosing algorithm for gonadotropins among Japanese patients. Our calculator will improve controlled ovarian stimulation performance and enable national standardization by allowing all physicians, regardless of their years of experience, to determine the appropriate starting dose of gonadotropins equally.
创建一种用于控制性卵巢刺激的促性腺激素起始剂量计算器,该计算器可根据各机构的目标卵母细胞数量和刺激持续时间进行调整,以实现日本患者个体化的控制性卵巢刺激。
患者采用促性腺激素释放激素拮抗剂方案接受控制性卵巢刺激,并取卵。通过单因素回归分析,我们选择年龄、抗苗勒管激素(AMH)和初始血清卵泡刺激素作为变量,以预测每剂促性腺激素获取的卵母细胞数量(卵母细胞敏感性指数)。然后对每个变量进行向后逐步多元回归分析。
从向后逐步多元回归中选择年龄和AMH作为预测变量,并建立了多元回归方程。我们将该方程分解为获取的卵母细胞数量/(促性腺激素起始剂量×刺激持续天数),并创建了一个计算公式,用于根据目标卵母细胞数量和刺激持续天数预测促性腺激素起始剂量。
这是第一项针对日本患者开发促性腺激素个体化给药算法的研究。我们的计算器将改善控制性卵巢刺激的效果,并通过使所有医生,无论其经验年限如何,都能平等地确定促性腺激素的合适起始剂量,从而实现全国标准化。