来曲唑诱导多囊卵巢综合征妇女排卵反应的预测因素评价:一项前瞻性队列研究。

Q2 Medicine Journal of Human Reproductive Sciences Pub Date : 2024-10-01 Epub Date: 2024-12-23 DOI:10.4103/jhrs.jhrs_133_24
Shanti Tholiya, Archana Kumari, Reeta Mahey, Mani Kalaivani, Hem Chandra Sati, Mona Sharma, Aarthi K Jayraj, Neena Malhotra
{"title":"来曲唑诱导多囊卵巢综合征妇女排卵反应的预测因素评价:一项前瞻性队列研究。","authors":"Shanti Tholiya, Archana Kumari, Reeta Mahey, Mani Kalaivani, Hem Chandra Sati, Mona Sharma, Aarthi K Jayraj, Neena Malhotra","doi":"10.4103/jhrs.jhrs_133_24","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Ovulation induction (OI) in patients with polycystic ovary syndrome (PCOS) remains challenging, and several biomarkers have been evaluated for their ability to predict ovulation. The predictive ability of candidate biomarkers, particularly with letrozole-based therapy in infertile PCOS women, remains inconclusive as it is yet to be evaluated in a prospective study.</p><p><strong>Aim: </strong>To assess the role of anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), luteinising hormone (LH)/FSH ratio, testosterone and free androgen index (FAI) as predictors of ovarian response to letrozole-based OI therapy during OI cycles in infertile women with PCOS from North India.</p><p><strong>Settings and design: </strong>A prospective cohort study was conducted in a tertiary care hospital in north India.</p><p><strong>Materials and methods: </strong>The study enrolled 80 infertile women with PCOS, diagnosed according to the Rotterdam criteria. OI was conducted using letrozole with or without human menopausal gonadotropin. Baseline endocrine and metabolic parameters, including serum AMH, FSH, LH, testosterone and FAI levels, were measured using ELISA or chemiluminescence methods on day 2 of the menstrual cycle. Follicular response to OI was monitored by transvaginal ultrasonography.</p><p><strong>Statistical analysis used: </strong>Descriptive and inferential statistical analyses were conducted, including Mann-Whitney, Kruskal-Wallis, Independent <i>t</i>-test, analysis of variance, Fisher's exact test and receiver operating characteristic curve analysis. Data were processed using Microsoft Excel and analysed with SPSS software, version 25.0. <i>P</i> < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Of 80 women enrolled, 74 responded to letrozole-based OI, while six were non-responders. Body mass index (BMI), serum testosterone and pre-treatment AMH levels significantly correlated with follicular response, with higher values linked to reduced responsiveness. The likelihood ratio+ (95% confidence interval) was 3.32 (2.45-5.06) for AMH, 1.97 (1.03-3.78) for BMI and 1.93 (1.22-3.08) for testosterone. The odds ratio for AMH was 2.88 (1.01-8.21) and 1.25 (1.02-1.53) for BMI. An AMH cut-off of ≤16.43 ng/mL predicted ovarian response with an AUC of 0.88.</p><p><strong>Conclusions: </strong>Pre-treatment AMH levels, along with BMI and serum testosterone, are significant predictors of ovarian response to letrozole-based OI in infertile women with PCOS.</p>","PeriodicalId":15975,"journal":{"name":"Journal of Human Reproductive Sciences","volume":"17 4","pages":"240-245"},"PeriodicalIF":0.0000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11741119/pdf/","citationCount":"0","resultStr":"{\"title\":\"Evaluation of Predictors of Response to Ovulation Induction Using Letrozole in Women with Polycystic Ovary Syndrome: A Prospective Cohort Study.\",\"authors\":\"Shanti Tholiya, Archana Kumari, Reeta Mahey, Mani Kalaivani, Hem Chandra Sati, Mona Sharma, Aarthi K Jayraj, Neena Malhotra\",\"doi\":\"10.4103/jhrs.jhrs_133_24\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Ovulation induction (OI) in patients with polycystic ovary syndrome (PCOS) remains challenging, and several biomarkers have been evaluated for their ability to predict ovulation. The predictive ability of candidate biomarkers, particularly with letrozole-based therapy in infertile PCOS women, remains inconclusive as it is yet to be evaluated in a prospective study.</p><p><strong>Aim: </strong>To assess the role of anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), luteinising hormone (LH)/FSH ratio, testosterone and free androgen index (FAI) as predictors of ovarian response to letrozole-based OI therapy during OI cycles in infertile women with PCOS from North India.</p><p><strong>Settings and design: </strong>A prospective cohort study was conducted in a tertiary care hospital in north India.</p><p><strong>Materials and methods: </strong>The study enrolled 80 infertile women with PCOS, diagnosed according to the Rotterdam criteria. OI was conducted using letrozole with or without human menopausal gonadotropin. Baseline endocrine and metabolic parameters, including serum AMH, FSH, LH, testosterone and FAI levels, were measured using ELISA or chemiluminescence methods on day 2 of the menstrual cycle. Follicular response to OI was monitored by transvaginal ultrasonography.</p><p><strong>Statistical analysis used: </strong>Descriptive and inferential statistical analyses were conducted, including Mann-Whitney, Kruskal-Wallis, Independent <i>t</i>-test, analysis of variance, Fisher's exact test and receiver operating characteristic curve analysis. Data were processed using Microsoft Excel and analysed with SPSS software, version 25.0. <i>P</i> < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Of 80 women enrolled, 74 responded to letrozole-based OI, while six were non-responders. Body mass index (BMI), serum testosterone and pre-treatment AMH levels significantly correlated with follicular response, with higher values linked to reduced responsiveness. The likelihood ratio+ (95% confidence interval) was 3.32 (2.45-5.06) for AMH, 1.97 (1.03-3.78) for BMI and 1.93 (1.22-3.08) for testosterone. The odds ratio for AMH was 2.88 (1.01-8.21) and 1.25 (1.02-1.53) for BMI. An AMH cut-off of ≤16.43 ng/mL predicted ovarian response with an AUC of 0.88.</p><p><strong>Conclusions: </strong>Pre-treatment AMH levels, along with BMI and serum testosterone, are significant predictors of ovarian response to letrozole-based OI in infertile women with PCOS.</p>\",\"PeriodicalId\":15975,\"journal\":{\"name\":\"Journal of Human Reproductive Sciences\",\"volume\":\"17 4\",\"pages\":\"240-245\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11741119/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Human Reproductive Sciences\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4103/jhrs.jhrs_133_24\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/12/23 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Human Reproductive Sciences","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/jhrs.jhrs_133_24","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/23 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0

摘要

背景:多囊卵巢综合征(PCOS)患者的促排卵(OI)仍然具有挑战性,一些生物标志物已经被评估其预测排卵的能力。候选生物标志物的预测能力,特别是对不孕症多囊卵巢综合征妇女的来曲唑治疗,仍然没有定论,因为它尚未在一项前瞻性研究中进行评估。目的:评估抗勒氏激素(AMH)、卵泡刺激素(FSH)、促黄体生成素(LH)/FSH比值、睾酮和游离雄激素指数(FAI)在印度北部多囊卵巢综合征(PCOS)不孕妇女成骨不全周期中对来曲唑为基础的成骨不全治疗的卵巢反应的预测作用。背景和设计:在印度北部的一家三级医院进行了一项前瞻性队列研究。材料和方法:本研究招募了80名根据鹿特丹标准诊断为多囊卵巢综合征的不孕妇女。成骨不全是用来曲唑加或不加人绝经期促性腺激素进行的。在月经周期第2天采用ELISA或化学发光法测定基线内分泌和代谢参数,包括血清AMH、FSH、LH、睾酮和FAI水平。经阴道超声检查监测卵泡对OI的反应。统计分析方法:采用描述性统计分析和推断性统计分析,包括Mann-Whitney、Kruskal-Wallis、独立t检验、方差分析、Fisher精确检验和受试者工作特征曲线分析。数据采用Microsoft Excel处理,SPSS软件25.0进行分析。P < 0.05为差异有统计学意义。结果:入组的80名女性中,74名对来曲唑型成骨不全有反应,6名无反应。身体质量指数(BMI)、血清睾酮和治疗前AMH水平与卵泡反应显著相关,数值越高反应性越低。AMH的似然比为3.32 (2.45-5.06),BMI的似然比为1.97(1.03-3.78),睾酮的似然比为1.93(1.22-3.08)。AMH的比值比为2.88 (1.01-8.21),BMI为1.25(1.02-1.53)。AMH截止值≤16.43 ng/mL预测卵巢反应,AUC为0.88。结论:治疗前AMH水平,以及BMI和血清睾酮水平,是来曲唑为基础的多囊卵巢成骨不全不孕妇女卵巢反应的重要预测指标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Evaluation of Predictors of Response to Ovulation Induction Using Letrozole in Women with Polycystic Ovary Syndrome: A Prospective Cohort Study.

Background: Ovulation induction (OI) in patients with polycystic ovary syndrome (PCOS) remains challenging, and several biomarkers have been evaluated for their ability to predict ovulation. The predictive ability of candidate biomarkers, particularly with letrozole-based therapy in infertile PCOS women, remains inconclusive as it is yet to be evaluated in a prospective study.

Aim: To assess the role of anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), luteinising hormone (LH)/FSH ratio, testosterone and free androgen index (FAI) as predictors of ovarian response to letrozole-based OI therapy during OI cycles in infertile women with PCOS from North India.

Settings and design: A prospective cohort study was conducted in a tertiary care hospital in north India.

Materials and methods: The study enrolled 80 infertile women with PCOS, diagnosed according to the Rotterdam criteria. OI was conducted using letrozole with or without human menopausal gonadotropin. Baseline endocrine and metabolic parameters, including serum AMH, FSH, LH, testosterone and FAI levels, were measured using ELISA or chemiluminescence methods on day 2 of the menstrual cycle. Follicular response to OI was monitored by transvaginal ultrasonography.

Statistical analysis used: Descriptive and inferential statistical analyses were conducted, including Mann-Whitney, Kruskal-Wallis, Independent t-test, analysis of variance, Fisher's exact test and receiver operating characteristic curve analysis. Data were processed using Microsoft Excel and analysed with SPSS software, version 25.0. P < 0.05 was considered statistically significant.

Results: Of 80 women enrolled, 74 responded to letrozole-based OI, while six were non-responders. Body mass index (BMI), serum testosterone and pre-treatment AMH levels significantly correlated with follicular response, with higher values linked to reduced responsiveness. The likelihood ratio+ (95% confidence interval) was 3.32 (2.45-5.06) for AMH, 1.97 (1.03-3.78) for BMI and 1.93 (1.22-3.08) for testosterone. The odds ratio for AMH was 2.88 (1.01-8.21) and 1.25 (1.02-1.53) for BMI. An AMH cut-off of ≤16.43 ng/mL predicted ovarian response with an AUC of 0.88.

Conclusions: Pre-treatment AMH levels, along with BMI and serum testosterone, are significant predictors of ovarian response to letrozole-based OI in infertile women with PCOS.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Journal of Human Reproductive Sciences
Journal of Human Reproductive Sciences Medicine-Reproductive Medicine
CiteScore
2.60
自引率
0.00%
发文量
50
审稿时长
23 weeks
期刊介绍: The Journal of Human Reproductive Sciences (JHRS) (ISSN:0974-1208) a Quarterly peer-reviewed international journal is being launched in January 2008 under the auspices of Indian Society of Assisted Reproduction. The journal will cover all aspects human reproduction including Andrology, Assisted conception, Endocrinology, Physiology and Pathology, Implantation, Preimplantation Diagnosis, Preimplantation Genetic Diagnosis, Embryology as well as Ethical, Legal and Social issues. The journal will publish peer-reviewed original research papers, case reports, systematic reviews, meta-analysis, and debates.
期刊最新文献
An Integrative Approach to Precision Pre-implantation Genetic Diagnosis by Investigating Single-cell Sequencing, Polygenic Risk Assessment, Artificial Intelligence-guided Embryo Selection and Genome Editing in Embryos with COL4A1 c.1537G>A Mutation. Evaluation of Predictors of Response to Ovulation Induction Using Letrozole in Women with Polycystic Ovary Syndrome: A Prospective Cohort Study. First-trimester Doppler Ultrasound for Predicting Successful Management of Pregnancy with Recurrent Pregnancy Losses Due to Antiphospholipid Syndrome and Thrombophilia: A Cohort Study. Assessment of Thyroid Auto-antibodies in Euthyroid Infertile Women with Polycystic Ovarian Syndrome - A Cross-sectional Analytical Study. Detection of Lactoferrin and Iron in Seminal Plasma and Their Possible Relation to Semen Parameters and Infertility in Varicocele: A Cross-sectional Study.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1