Wang Qiaoling, Lang Jingwen, Zhi Yunqing, Zhu Xiuxian, Fu Yonglun
Department of Assisted Reproductive Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, 2699nd West Gao Ke Road, Shanghai, 201204, China.
Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China.
J Assist Reprod Genet. 2025 Mar;42(3):865-874. doi: 10.1007/s10815-024-03386-1. Epub 2025 Jan 14.
Women with polycystic ovary syndrome (PCOS) show greater heterogeneity in ovarian responses during ovarian stimulation. We aimed to investigate the potential predicting factors among individualized basic parameters that affect poor or hyper ovarian responses in PCOS patients.
We retrospectively screened 2058 women with PCOS who underwent their first cycle of in vitro fertilization/intracytoplasmic sperm injection. Spearman correlation analysis and multivariable linear regression model were applied to screen potential variables impacting the number of oocyte retrieved. Further, women with PCOS were divided into poor, sub-optimal, optimal, and hyper responders based on oocyte-retrieved numbers. Logistic regression model and receiver operating characteristic (ROC) curve were used to testify the predicting effect of screened parameters on ovarian response.
Multivariable linear regression showed that body mass index (BMI) and follicle-stimulating hormone (FSH) were significantly negatively correlated with oocyte numbers, while luteinizing hormone and anti-Müllerian hormone (AMH) showed a positive correlation. Logistic regression model showed that high BMI (RR: 1.141, 95% CI: 1.090, 1.195) and FSH (RR: 1.161, 95% CI: 1.043, 1.293) were risk factors for poor and sub-optimal ovarian response, but not for hyper response. High AMH level was a risk factor (RR: 1.118, 95% CI: 1.075, 1.163) for hyper ovarian response. The optimal cutoff value was BMI = 23.25 kg/cm, FSH = 6.375 IU/L, and AMH = 9.8 ng/mL, respectively.
Individualized basic parameters including BMI, FSH, and AMH are crucial for predicting ovarian response of women with PCOS, providing valuable information for formulating personalized diagnosis and treatment plans.
多囊卵巢综合征(PCOS)女性在卵巢刺激过程中卵巢反应表现出更大的异质性。我们旨在研究影响PCOS患者卵巢反应不良或过度的个体化基本参数中的潜在预测因素。
我们回顾性筛选了2058例接受首次体外受精/卵胞浆内单精子注射周期的PCOS女性。应用Spearman相关性分析和多变量线性回归模型筛选影响获卵数的潜在变量。此外,根据获卵数将PCOS女性分为反应不良、次优、最佳和反应过度组。采用逻辑回归模型和受试者工作特征(ROC)曲线验证筛选参数对卵巢反应的预测效果。
多变量线性回归显示,体重指数(BMI)和促卵泡生成素(FSH)与卵母细胞数量显著负相关,而促黄体生成素和抗苗勒管激素(AMH)呈正相关。逻辑回归模型显示,高BMI(RR:1.141,95%CI:1.090,1.195)和FSH(RR:1.161,95%CI:1.043,1.293)是卵巢反应不良和次优的危险因素,但不是反应过度的危险因素。高AMH水平是卵巢反应过度的危险因素(RR:1.118,95%CI:1.075,1.163)。最佳截断值分别为BMI = 23.25 kg/cm²、FSH = 6.375 IU/L和AMH = 9.8 ng/mL。
包括BMI、FSH和AMH在内的个体化基本参数对于预测PCOS女性的卵巢反应至关重要,为制定个性化诊断和治疗方案提供了有价值的信息。