临床因素与波赛顿标准患者意外的不良或低于最佳反应相关
Alyssa Hochberg1, Michael H Dahan2, Hakan Yarali3
1Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada.; The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel..
Reproductive biomedicine online
|April 24, 2024
概括
这项研究确定了临床因素和高于预期的抗米勒尔激素 (AMH) 和前卵泡计数 (AFC) 值,与IVF卵巢刺激中意想不到的低或低于最佳反应相关. 这些发现有助于个性化生育治疗.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 在体外受精 (IVF)
背景情况:
- 了解卵巢反应的预测因素对于优化试管婴儿结果至关重要.
- 波赛顿的分类确定了患有卵巢反应不良风险的患者.
- 识别"意想不到"的低或低于最佳响应者需要进一步调查相关的临床因素和生物标志物值.
研究的目的:
- 确定与常规试管婴儿卵巢刺激意外不良或低于最佳反应相关的临床因素.
- 为了确定特定的抗米勒尔激素 (AMH) 和腹卵泡计数 (AFC) 值,以区分这一患者群体.
主要方法:
- 追溯的队列研究7625首次试管婴儿/ICSI周期与传统的卵巢刺激.
- 患者符合POSEIDON关于足够的卵巢储备的标准 (AMH≥1.2 ng/ml;AFC≥5).
- 使用后勤回归和ROC曲线分析来确定预测因素和值.
主要成果:
- 较差/低于最佳反应的重要预测因素包括AFC,AMH,淋巴腺素剂量/类型和触发型.
- 预测不良/低于最佳反应的值是AMH 2.87 ng/ml和AFC 12.
- 预测不良反应的值是AMH 2.17 ng/ml和AFC 9;对于次优反应,AMH 2.97 ng/ml和AFC 12.
结论:
- 对于意想不到的不良或不理想的试管婴儿反应,已确定的AMH和AFC值高于此前预期的.
- 这些发现需要对试管婴儿刺激方案和淋巴腺素剂量进行调整,以提供个性化的患者护理.
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