针对中度/严重的OHSS进行优化个性化管理方法:开发和未来验证OHSS风险评估指数
Mingzhu Cao1, Qiwang Lin1, Zhi Liu2
1Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Human reproduction (Oxford, England)
|September 5, 2024
概括
开发并验证了一种简化的卵巢过度刺激综合征 (OHSS) 风险评估指数. 该工具准确地预测OHSS风险,帮助个性化患者咨询和生殖医学中的管理.
科学领域:
- 生殖医学 生殖医学
- 妇科 妇科 妇科 妇科
- 不孕症治疗 不孕症治疗
背景情况:
- 卵巢过度刺激综合征 (OHSS) 在辅助生殖技术中存在风险.
- 现有的OHSS风险评估工具可能缺乏广泛临床使用的便利性.
- 对于早期检测和预防,需要一个简化,易于应用的OHSS风险指数.
研究的目的:
- 开发和验证一个简化,多阶段的风险评估指数,适度/严重的OHSS.
- 为了评估指数的区分能力和校准准确度.
- 在OHSS预防中提供早期预警和风险分层的工具.
主要方法:
- 从15,066到8,097个周期的回顾性和前性队列数据被用于培训和验证.
- 建立了一个多阶段的风险评估指数,包括刺激前,触发前,卵细胞检索后和胚胎移植日的评估点.
- 使用C统计和校准图表来评估指数在歧视和准确性方面的表现.
主要成果:
- 简化OHSS风险评估指数表明,从第一阶段到第三阶段的歧视越来越多 (C统计数据从0.626到0.788).
- 校准图表显示,所有队列中观察到和预测的OHSS病例之间存在很高的一致性.
- 在各个风险层 (0%至8.5%) 中,OHSS的发生率差异很大,这表明有效的风险分层.
结论:
- 开发的OHSS风险评估指数是预测OHSS风险的可靠工具.
- 该指数在内部和外部验证中显示出良好的区分能力和校准准确性.
- 该工具可以为OHSS提供个性化咨询和管理策略.
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