Predicting factors of ovarian responses in infertile women with polycystic ovary syndrome undergoing IVF/ICSI.

IF 3.2 3区 医学 Q2 GENETICS & HEREDITY Journal of Assisted Reproduction and Genetics Pub Date : 2025-01-14 DOI:10.1007/s10815-024-03386-1
Qiaoling Wang, Jingwen Lang, Yunqing Zhi, Xiuxian Zhu, Yonglun Fu
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Abstract

Purpose: 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.

Methods: 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.

Results: 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/cm2, FSH = 6.375 IU/L, and AMH = 9.8 ng/mL, respectively.

Conclusions: 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.

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预测接受IVF/ICSI治疗的多囊卵巢综合征不孕妇女卵巢反应的因素
目的:多囊卵巢综合征(PCOS)女性在卵巢刺激过程中表现出更大的卵巢反应异质性。我们的目的是探讨影响PCOS患者卵巢反应差或高的个体化基本参数的潜在预测因素。方法:我们回顾性筛选了2058名接受第一轮体外受精/胞浆内单精子注射的PCOS女性。采用Spearman相关分析和多变量线性回归模型筛选影响取卵数量的潜在变量。此外,根据卵母细胞计数将PCOS患者分为不良反应、次优反应、最佳反应和超反应。采用Logistic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。结果:多变量线性回归显示,体重指数(BMI)、促卵泡激素(FSH)与卵母细胞数量呈显著负相关,黄体生成素(lutein生成素)、抗勒氏激素(AMH)与卵母细胞数量呈显著正相关。Logistic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)是卵巢不良反应和次优反应的危险因素,而非高反应的危险因素。高AMH水平是卵巢高反应的危险因素(RR: 1.118, 95% CI: 1.075, 1.163)。最佳临界值分别为BMI = 23.25 kg/cm2、FSH = 6.375 IU/L、AMH = 9.8 ng/mL。结论:BMI、FSH、AMH等个体化基础参数对预测PCOS患者卵巢反应具有重要意义,可为制定个体化诊断和治疗方案提供有价值的信息。
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来源期刊
CiteScore
5.70
自引率
9.70%
发文量
286
审稿时长
1 months
期刊介绍: The Journal of Assisted Reproduction and Genetics publishes cellular, molecular, genetic, and epigenetic discoveries advancing our understanding of the biology and underlying mechanisms from gametogenesis to offspring health. Special emphasis is placed on the practice and evolution of assisted reproduction technologies (ARTs) with reference to the diagnosis and management of diseases affecting fertility. Our goal is to educate our readership in the translation of basic and clinical discoveries made from human or relevant animal models to the safe and efficacious practice of human ARTs. The scientific rigor and ethical standards embraced by the JARG editorial team ensures a broad international base of expertise guiding the marriage of contemporary clinical research paradigms with basic science discovery. JARG publishes original papers, minireviews, case reports, and opinion pieces often combined into special topic issues that will educate clinicians and scientists with interests in the mechanisms of human development that bear on the treatment of infertility and emerging innovations in human ARTs. The guiding principles of male and female reproductive health impacting pre- and post-conceptional viability and developmental potential are emphasized within the purview of human reproductive health in current and future generations of our species. The journal is published in cooperation with the American Society for Reproductive Medicine, an organization of more than 8,000 physicians, researchers, nurses, technicians and other professionals dedicated to advancing knowledge and expertise in reproductive biology.
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