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一种用于预测卵母细胞冷冻保存周期中促性腺激素剂量和卵母细胞产量的新型计算器的开发。

Development of a novel calculator to predict gonadotropin dose and oocyte yield in oocyte cryopreservation cycles.

作者信息

Yilmaz Bahar D, Bakkensen Jennifer, Yeh Chen, Muhammad Lutfiyya N, Feinberg Eve C

机构信息

Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Northwestern University, Chicago, IL, USA.

Department of Obstetrics, Gynecology & Reproductive Sciences, Division of Reproductive Endocrinology and Infertility, University of California, San Francisco, San Francisco, CA, USA.

出版信息

J Assist Reprod Genet. 2025 Feb;42(2):423-432. doi: 10.1007/s10815-024-03372-7. Epub 2025 Jan 7.

Abstract

PURPOSE

To develop a predictive model for estimating the total dose of gonadotropins and the number mature oocytes in planned oocyte cryopreservation cycles.

METHODS

In this retrospective study, oocyte cryopreservation cycles recorded in the Society for Assisted Reproductive Technology Clinic Outcome Reporting System Database from 2013 to 2018 were analyzed. Bivariate copula additive models for location, scale, and shape were performed to create a predictive model for estimating total dose of gonadotropins and number of mature oocytes.

RESULTS

A total of 15,806 oocyte cryopreservation cycles between 2013 and 2018 were included in the analysis. The average age of participants was 35.4 years, the mean duration of stimulation was 11.8 days, and the average number of mature oocytes retrieved was 11.8. The treatment dose increased with age, FSH levels, BMI ≥ 35 kg/m, smoking, and history of diminished ovarian reserve, while it decreased with increasing AMH, ovulatory disorder, and BMI < 25 kg/m. The number of mature oocytes retrieved was positively correlated with AMH and negatively correlated with age, FSH levels, Asian race, and diminished ovarian reserve. With a maximum gonadotropin dosage of 450 IU per day for 12 ± 3 days of stimulation and a tolerance level of six mature oocytes, the predictive model achieved 70% accuracy. An interactive version of the equation was created as an online tool.

CONCLUSIONS

We developed a predictive model to estimate the total treatment dosage and the number of mature oocytes. This calculator, utilizing objective patient variables, can assist in patient counseling prior to planned oocyte cryopreservation cycles.

摘要

目的

建立一个预测模型,用于估计计划中的卵母细胞冷冻保存周期中促性腺激素的总剂量和成熟卵母细胞的数量。

方法

在这项回顾性研究中,分析了2013年至2018年辅助生殖技术协会诊所结果报告系统数据库中记录的卵母细胞冷冻保存周期。采用位置、尺度和形状的双变量copula加法模型来创建一个预测模型,以估计促性腺激素的总剂量和成熟卵母细胞的数量。

结果

分析纳入了2013年至2018年间的15806个卵母细胞冷冻保存周期。参与者的平均年龄为35.4岁,平均刺激持续时间为11.8天,平均回收的成熟卵母细胞数量为11.8个。治疗剂量随着年龄、促卵泡激素(FSH)水平、体重指数(BMI)≥35kg/m²、吸烟以及卵巢储备功能减退史而增加,而随着抗缪勒管激素(AMH)升高、排卵障碍以及BMI<25kg/m²而降低。回收的成熟卵母细胞数量与AMH呈正相关,与年龄、FSH水平、亚洲种族以及卵巢储备功能减退呈负相关。在刺激12±3天且促性腺激素最大剂量为每天450IU以及六个成熟卵母细胞的耐受水平下,该预测模型的准确率达到70%。创建了该方程的交互式版本作为在线工具。

结论

我们开发了一个预测模型来估计总治疗剂量和成熟卵母细胞的数量。这个利用客观患者变量的计算器可以在计划的卵母细胞冷冻保存周期之前协助患者咨询。

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