卵巢敏感性指数影响促性腺激素释放激素激动剂和拮抗剂受精周期的临床妊娠率和活产率。
Ovarian sensitivity index affects clinical pregnancy and live birth rates in gonadotropin-releasing hormone agonist and antagonist fertilization cycles.
作者信息
Hsu Chao Chin, Hsu Isabel, Dorjee Sonam, Chen Yi Chun, Chen Tzu Ning, Chuang Yu Lin
机构信息
Taiwan United Birth-Promoting Experts Fertility Clinic, Tainan, Taiwan.
Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan.
出版信息
Front Endocrinol (Lausanne). 2024 Dec 13;15:1457435. doi: 10.3389/fendo.2024.1457435. eCollection 2024.
OBJECTIVES
This study aimed to investigate the correlation of ovarian sensitivity index (OSI) and clinical parameters in IVF treatments.
METHODS
IVF data files between January 2011 and December 2020 in a single unit were included. The primary outcome measure was the correlation between the OSI and clinical pregnancy and live birth rates. A generalized linear model was employed to assess group differences while controlling for age. Correlations between the OSI and clinical parameters were analyzed using Pearson's correlation test.
RESULTS
In total, 1,627 patient data were reviewed, comprising 1,160 patients who received GnRH antagonists and 467 who received GnRH agonists. There was no difference in the incidence of premature ovulation and LH surge in women receiving either GnRH antagonists or agonists. A higher number of mature oocytes and good embryos were obtained in the GnRH agonist cycles. No differences were observed in pregnancy and live birth rates between both groups. Regarding the correlation of the OSI with clinical parameters, serum anti-Müllerian hormone, cycle day 2 follicle-stimulating hormone, LH, and estradiol concentrations, numbers of larger follicles, fertilization rate, and the incidence of premature LH surge were positively correlated with the OSI. Whereas the body mass index, mature oocytes obtained, embryo transfer number, and dose of GnRH antagonists were negatively correlated with the OSI. In the GnRH antagonists group, an OSI of 225.75 significantly distinguished pregnancy from non-pregnancy (p < 0.001), with an AUC of 0.615, and an OSI of 208.62 significantly distinguished live births from non-live births (p < 0.001), with an AUC of 0.637. As for the GnRH agonist group, an OSI of 228 significantly distinguished live births from non-live births, (p =0.020) with an AUC of 0.569.
CONCLUSION
We demonstrated the capability of employing OSI to distinguish the clinical pregnancy and live birth outcomes in IVF cycles.
目的
本研究旨在探讨体外受精（IVF）治疗中卵巢敏感性指数（OSI）与临床参数之间的相关性。
方法
纳入2011年1月至2020年12月在单一机构的IVF数据文件。主要观察指标为OSI与临床妊娠率和活产率之间的相关性。采用广义线性模型评估组间差异，同时控制年龄因素。使用Pearson相关检验分析OSI与临床参数之间的相关性。
结果
共审查了1627例患者的数据，其中1160例接受促性腺激素释放激素（GnRH）拮抗剂治疗，467例接受GnRH激动剂治疗。接受GnRH拮抗剂或激动剂治疗的女性中，过早排卵和促黄体生成素（LH）峰的发生率无差异。在GnRH激动剂周期中获得了更多的成熟卵母细胞和优质胚胎。两组之间的妊娠率和活产率未观察到差异。关于OSI与临床参数的相关性，血清抗苗勒管激素、周期第2天卵泡刺激素、LH和雌二醇浓度、较大卵泡数量、受精率以及过早LH峰的发生率与OSI呈正相关。而体重指数、获得的成熟卵母细胞数量、胚胎移植数量和GnRH拮抗剂剂量与OSI呈负相关。在GnRH拮抗剂组中，OSI为225.75时显著区分妊娠与非妊娠（p<0.001），曲线下面积（AUC）为0.615；OSI为208.62时显著区分活产与非活产（p<0.001），AUC为0.637。至于GnRH激动剂组，OSI为228时显著区分活产与非活产（p =0.020），AUC为0.569。
结论
我们证明了使用OSI区分IVF周期中临床妊娠和活产结局的能力。
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