Lobo Rita, Falahati Ali, Moley Kelle, Pinborg Anja, Santos-Ribeiro Samuel, Macklon Nick S, Jepsen Ida E
Ferring Pharmaceuticals, Global Research and Medical, Copenhagen, Denmark.
Ferring Pharmaceuticals, Global Biometrics, Copenhagen, Denmark.
Reprod Biomed Online. 2025 Feb;50(2):104451. doi: 10.1016/j.rbmo.2024.104451. Epub 2024 Sep 19.
What number of retrieved oocytes is associated with the optimum chance of achieving a live birth for women undergoing ovarian stimulation with individualized follitropin delta?
An individual patient data meta-analysis was performed on 1772 patients from five randomized controlled trials using individualized follitropin delta for ovarian stimulation with fixed daily dosing based on serum anti-Müllerian hormone (AMH) level and body weight. Live birth rate (LBR) and ovarian hyperstimulation syndrome (OHSS) were evaluated in relation to the number of oocytes retrieved. Predicted LBR was obtained using a logistic regression analysis with fractional polynomials. Subgroup analyses were performed based on number of oocytes retrieved, age and AMH level.
The analysis included patients treated with follitropin delta who had at least one oocyte retrieved. The mean number of oocytes retrieved was 10.4, and overall LBR was 32.1%. Predicted LBR increased with the number of oocytes retrieved, reaching >34% for patients with 8-14 oocytes retrieved, and peaking at 34.9% for patients with 11 oocytes retrieved. LBR declined gradually beyond retrieval of 14 oocytes. LBR was 27.8%, 33.6% and 30.9% for patients with 1-7, 8-14, and ≥15 oocytes retrieved, respectively. LBR decreased with increasing age: 32.7%, 30.7% and 23.4% at <35, 35-37 and 38-42 years, respectively. The incidence of OHSS (any grade) was 2.1%, 5.2% and 17.0% for patients with 1-7, 8-14, and ≥15 oocytes retrieved, respectively.
After ovarian stimulation with individualized follitropin delta, LBR in fresh transfer cycles was highest for patients with 8-14 oocytes retrieved, and peaked in patients with 11 oocytes retrieved. The results support the appropriateness of the follitropin delta dosing algorithm.
对于接受个性化促卵泡素δ卵巢刺激的女性，获取多少枚卵母细胞与实现活产的最佳机会相关？
对来自五项随机对照试验的1772名患者进行了个体患者数据荟萃分析，这些患者使用基于血清抗苗勒管激素（AMH）水平和体重的固定每日剂量的个性化促卵泡素δ进行卵巢刺激。根据获取的卵母细胞数量评估活产率（LBR）和卵巢过度刺激综合征（OHSS）。使用带有分数多项式的逻辑回归分析获得预测的LBR。根据获取的卵母细胞数量、年龄和AMH水平进行亚组分析。
分析纳入了至少获取一枚卵母细胞的接受促卵泡素δ治疗的患者。获取的卵母细胞的平均数量为10.4枚，总体活产率为32.1%。预测的活产率随着获取的卵母细胞数量增加而升高，获取8 - 14枚卵母细胞的患者活产率>34%，获取11枚卵母细胞的患者活产率峰值为34.9%。获取超过14枚卵母细胞后，活产率逐渐下降。获取1 - 7枚、8 - 14枚和≥15枚卵母细胞的患者活产率分别为27.8%、33.6%和30.9%。活产率随着年龄增加而降低：<35岁、35 - 37岁和38 - 42岁的患者活产率分别为32.7%、30.7%和23.4%。获取1 - 7枚、8 - 14枚和≥15枚卵母细胞的患者OHSS（任何级别）的发生率分别为2.1%、5.2%和17.0%。
在使用个性化促卵泡素δ进行卵巢刺激后，新鲜移植周期中，获取8 - 14枚卵母细胞的患者活产率最高，获取11枚卵母细胞的患者活产率达到峰值。结果支持促卵泡素δ给药算法的合理性。
