Document Detail


A simple multivariate score could predict ovarian reserve, as well as pregnancy rate, in infertile women.
MedLine Citation:
PMID:  19368907     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To find a simple multivariate score that has the potential to predict ovarian reserve, as well as pregnancy rate, in infertile women. DESIGN: A prospective study. SETTING: A university-affiliated reproductive medicine unit. PATIENT(S): One hundred sixty-eight consecutive women undergoing their first IVF-ET treatment at our unit. INTERVENTION(S): Basal ovarian reserve studies, endocrine and sonographic, were performed before starting therapy. After completion of treatment, a logistic regression analysis was performed to examine which parameters significantly determined low ovarian reserve. These parameters were incorporated thereafter in a multivariate score to predict ovarian reserve, as well as clinical pregnancy rate. MAIN OUTCOME MEASURE(S): Low ovarian reserve defined as <or=3 oocytes on retrieval day and clinical implantation and pregnancy rates. RESULT(S): Logistic regression analysis revealed that age, antral follicle count, basal FSH, FSH/LH ratio, mean ovarian volume, infertility duration, number of previous cycle cancellations, and body mass index were all, in decreasing significance, independent factors that determine low ovarian reserve. The multivariate score was shown to have a distinctive prediction of ovarian reserve. A cumulative score of >14 was shown to be more accurate in predicting low ovarian reserve than age, day 3 FSH, or antral follicle count separately. Moreover, a score of >14 was shown to have a sensitivity of 88% and a specificity of 69% in predicting low ovarian reserve. More important, women with a score of >14 had significantly lower clinical implantation and pregnancy rates relative to women with a score of <or=14, corresponding to 6.7% versus 22.4%, and 11.3% versus 38.6%, respectively. CONCLUSION(S): A novel and simple multivariate score using clinical and basal endocrine and sonographic parameters has a distinctive prediction of low ovarian reserve in infertile women undergoing assisted reproductive technology treatment. Moreover, it has the potential to predict clinical implantation and pregnancy rates in women with low and good ovarian reserve.
Authors:
Johnny S Younis; Jimmy Jadaon; Ido Izhaki; Sami Haddad; Orit Radin; Shalom Bar-Ami; Moshe Ben-Ami
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Publication Detail:
Type:  Journal Article     Date:  2009-04-14
Journal Detail:
Title:  Fertility and sterility     Volume:  94     ISSN:  1556-5653     ISO Abbreviation:  Fertil. Steril.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-08     Completed Date:  2010-07-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  United States    
Other Details:
Languages:  eng     Pagination:  655-61     Citation Subset:  IM    
Copyright Information:
Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Obstetrics and Gynecology, Poriya Medical Center, Tiberias, Israel. jsy@netvision.net.il
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MeSH Terms
Descriptor/Qualifier:
Adult
Cell Count
Female
Fertilization in Vitro / statistics & numerical data*
Follicle Stimulating Hormone / blood
Humans
Infertility, Female / epidemiology*,  ultrasonography*
Logistic Models
Luteinizing Hormone / blood
Models, Statistical*
Multivariate Analysis
Ovarian Follicle / cytology,  physiology*
Predictive Value of Tests
Pregnancy
Pregnancy Rate*
Prospective Studies
Sensitivity and Specificity
Young Adult
Chemical
Reg. No./Substance:
9002-67-9/Luteinizing Hormone; 9002-68-0/Follicle Stimulating Hormone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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