Medical Center for Human Reproduction, Beijing Chao-Yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, China.
Jinxin Fertility Group, No. 301, North Jingsha Road, Jinjiang District, Chengdu, Sichuan, China.
BMC Womens Health. 2023 Feb 4;23(1):45. doi: 10.1186/s12905-023-02195-5.
With the development of assisted reproduction technology (ART), many indicators have been proposed to evaluate ovarian response, and then predict pregnancy outcomes. In general, the predictive values remain limited.
To further explore the indicators to evaluate ovarian sensitivity to gonadotrophin (Gn) stimulation more accurately.
This retrospective cohort study included 330 women who underwent an entire ART cycle. We aimed to assess whether a new index, termed as average Gn dosage per follicle, could be used as a marker for ovarian response and pregnancy outcomes. It was calculated as the ratio of total Gn dose during ovarian stimulation and the number of pre-ovulatory follicles (PFC) on the trigger day. Patients were divided into three subgroups according to the average Gn dosage per follicle: below the 33rd percentile (Group A), between 33rd and 67th percentiles (Group B), and above the 67th percentile (Group C). Then stimulation data, laboratory and clinical outcomes were compared among the groups.
The results showed patients in Group A had the best ovarian response, the number of retrieved oocytes was significantly higher than in Group B and C. A multivariate regression analysis showed that average Gn dosage per follicle was an independent predictor of cumulative live birth rates (CLBRs) [adjusted odds ratio (OR): 0.96, 95% confidence interval (CI): 0.95-0.98, P < 0.01].
The present study showed that average Gn dosage per follicle appears to be a highly reliable index of ovarian response to exogenous Gn and can be useful to estimate CLBR.
随着辅助生殖技术（ART）的发展，已经提出了许多指标来评估卵巢反应，进而预测妊娠结局。但总的来说，这些预测指标的预测价值仍然有限。
进一步探索更准确地评估卵巢对促性腺激素（Gn）刺激敏感性的指标。
本回顾性队列研究纳入了 330 名接受完整 ART 周期的女性。我们旨在评估一个新的指标，即每个卵泡的平均 Gn 剂量，是否可以作为卵巢反应和妊娠结局的标志物。它通过将卵巢刺激期间的总 Gn 剂量除以触发日的成熟卵泡（PFC）数量来计算。根据每个卵泡的平均 Gn 剂量，患者被分为三组：低于第 33 百分位数（A 组）、第 33 百分位至第 67 百分位（B 组）和高于第 67 百分位（C 组）。然后比较各组的刺激数据、实验室和临床结局。
结果显示，A 组患者的卵巢反应最佳，获卵数明显高于 B 组和 C 组。多变量回归分析显示，每个卵泡的平均 Gn 剂量是累积活产率（CLBRs）的独立预测因子[调整优势比（OR）：0.96，95%置信区间（CI）：0.95-0.98，P<0.01]。
本研究表明，每个卵泡的平均 Gn 剂量似乎是评估外源性 Gn 对卵巢反应的高度可靠指标，并可用于估计 CLBR。
