A new ovarian response prediction index (ORPI): implications for individualised controlled ovarian stimulation
Autor(a) principal: | |
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Data de Publicação: | 2012 |
Outros Autores: | , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNESP |
Texto Completo: | http://dx.doi.org/10.1186/1477-7827-10-94 http://hdl.handle.net/11449/12277 |
Resumo: | Background: The objective was to present a new ovarian response prediction index (ORPI), which was based on anti-Mullerian hormone (AMH) levels, antral follicle count (AFC) and age, and to verify whether it could be a reliable predictor of the ovarian stimulation response.Methods: A total of 101 patients enrolled in the ICSI programme were included. The ORPI values were calculated by multiplying the AMH level (ng/ml) by the number of antral follicles (2-9 mm), and the result was divided by the age (years) of the patient (ORPI=(AMH x AFC)/Patient age).Results: The regression analysis demonstrated significant (P<0.0001) positive correlations between the ORPI and the total number of oocytes and of MII oocytes collected. The logistic regression revealed that the ORPI values were significantly associated with the likelihood of pregnancy (odds ratio (OR): 1.86; P=0.006) and collecting greater than or equal to 4 oocytes (OR: 49.25; P<0.0001), greater than or equal to 4 MII oocytes (OR: 6.26; P<0.0001) and greater than or equal to 15 oocytes (OR: 6.10; P<0.0001). Regarding the probability of collecting greater than or equal to 4 oocytes according to the ORPI value, the ROC curve showed an area under the curve (AUC) of 0.91 and an efficacy of 88% at a cut-off of 0.2. In relation to the probability of collecting greater than or equal to 4 MII oocytes according to the ORPI value, the ROC curve had an AUC of 0.84 and an efficacy of 81% at a cut-off of 0.3. The ROC curve for the probability of collecting greater than or equal to 15 oocytes resulted in an AUC of 0.89 and an efficacy of 82% at a cut-off of 0.9. Finally, regarding the probability of pregnancy occurrence according to the ORPI value, the ROC curve showed an AUC of 0.74 and an efficacy of 62% at a cut-off of 0.3.Conclusions: The ORPI exhibited an excellent ability to predict a low ovarian response and a good ability to predict a collection of greater than or equal to 4 MII oocytes, an excessive ovarian response and the occurrence of pregnancy in infertile women. The ORPI might be used to improve the cost-benefit ratio of ovarian stimulation regimens by guiding the selection of medications and by modulating the doses and regimens according to the actual needs of the patients. |
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A new ovarian response prediction index (ORPI): implications for individualised controlled ovarian stimulationOvarian response prediction indexIndividualised controlled ovarian stimulationAnti-Mullerian hormoneAntral folliclesAgeBackground: The objective was to present a new ovarian response prediction index (ORPI), which was based on anti-Mullerian hormone (AMH) levels, antral follicle count (AFC) and age, and to verify whether it could be a reliable predictor of the ovarian stimulation response.Methods: A total of 101 patients enrolled in the ICSI programme were included. The ORPI values were calculated by multiplying the AMH level (ng/ml) by the number of antral follicles (2-9 mm), and the result was divided by the age (years) of the patient (ORPI=(AMH x AFC)/Patient age).Results: The regression analysis demonstrated significant (P<0.0001) positive correlations between the ORPI and the total number of oocytes and of MII oocytes collected. The logistic regression revealed that the ORPI values were significantly associated with the likelihood of pregnancy (odds ratio (OR): 1.86; P=0.006) and collecting greater than or equal to 4 oocytes (OR: 49.25; P<0.0001), greater than or equal to 4 MII oocytes (OR: 6.26; P<0.0001) and greater than or equal to 15 oocytes (OR: 6.10; P<0.0001). Regarding the probability of collecting greater than or equal to 4 oocytes according to the ORPI value, the ROC curve showed an area under the curve (AUC) of 0.91 and an efficacy of 88% at a cut-off of 0.2. In relation to the probability of collecting greater than or equal to 4 MII oocytes according to the ORPI value, the ROC curve had an AUC of 0.84 and an efficacy of 81% at a cut-off of 0.3. The ROC curve for the probability of collecting greater than or equal to 15 oocytes resulted in an AUC of 0.89 and an efficacy of 82% at a cut-off of 0.9. Finally, regarding the probability of pregnancy occurrence according to the ORPI value, the ROC curve showed an AUC of 0.74 and an efficacy of 62% at a cut-off of 0.3.Conclusions: The ORPI exhibited an excellent ability to predict a low ovarian response and a good ability to predict a collection of greater than or equal to 4 MII oocytes, an excessive ovarian response and the occurrence of pregnancy in infertile women. The ORPI might be used to improve the cost-benefit ratio of ovarian stimulation regimens by guiding the selection of medications and by modulating the doses and regimens according to the actual needs of the patients.Ctr Human Reprod Prof Franco Jr, Ribeirao Preto, Ribeirao, BrazilPaulista Ctr Diag Res & Training, Ribeirao Preto, Ribeirao, BrazilSão Paulo State Univ, Dept Obstet & Gynaecol, Botucatu Med Sch, UNESP, Botucatu, SP, BrazilPerola Byington Hosp, Womens Hlth Reference Ctr, São Paulo, Sao, BrazilSão Paulo State Univ, Dept Obstet & Gynaecol, Botucatu Med Sch, UNESP, Botucatu, SP, BrazilBiomed Central Ltd.Ctr Human Reprod Prof Franco JrPaulista Ctr Diag Res & TrainingUniversidade Estadual Paulista (Unesp)Perola Byington HospOliveira, Joao Batista A. [UNESP]Baruffi, Ricardo L. R.Petersen, Claudia G. [UNESP]Mauri, Ana L.Nascimento, Adriana M.Vagnini, LauraRicci, JulianaCavagna, MarioFranco, Jose G. [UNESP]2014-05-20T13:35:40Z2014-05-20T13:35:40Z2012-11-21info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article11application/pdfhttp://dx.doi.org/10.1186/1477-7827-10-94Reproductive Biology and Endocrinology. London: Biomed Central Ltd., v. 10, p. 11, 2012.1477-7827http://hdl.handle.net/11449/1227710.1186/1477-7827-10-94WOS:000314711300001WOS000314711300001.pdfWeb of Sciencereponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengReproductive Biology and Endocrinology2.8521,203info:eu-repo/semantics/openAccess2024-08-16T14:13:02Zoai:repositorio.unesp.br:11449/12277Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462024-08-16T14:13:02Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false |
dc.title.none.fl_str_mv |
A new ovarian response prediction index (ORPI): implications for individualised controlled ovarian stimulation |
title |
A new ovarian response prediction index (ORPI): implications for individualised controlled ovarian stimulation |
spellingShingle |
A new ovarian response prediction index (ORPI): implications for individualised controlled ovarian stimulation Oliveira, Joao Batista A. [UNESP] Ovarian response prediction index Individualised controlled ovarian stimulation Anti-Mullerian hormone Antral follicles Age |
title_short |
A new ovarian response prediction index (ORPI): implications for individualised controlled ovarian stimulation |
title_full |
A new ovarian response prediction index (ORPI): implications for individualised controlled ovarian stimulation |
title_fullStr |
A new ovarian response prediction index (ORPI): implications for individualised controlled ovarian stimulation |
title_full_unstemmed |
A new ovarian response prediction index (ORPI): implications for individualised controlled ovarian stimulation |
title_sort |
A new ovarian response prediction index (ORPI): implications for individualised controlled ovarian stimulation |
author |
Oliveira, Joao Batista A. [UNESP] |
author_facet |
Oliveira, Joao Batista A. [UNESP] Baruffi, Ricardo L. R. Petersen, Claudia G. [UNESP] Mauri, Ana L. Nascimento, Adriana M. Vagnini, Laura Ricci, Juliana Cavagna, Mario Franco, Jose G. [UNESP] |
author_role |
author |
author2 |
Baruffi, Ricardo L. R. Petersen, Claudia G. [UNESP] Mauri, Ana L. Nascimento, Adriana M. Vagnini, Laura Ricci, Juliana Cavagna, Mario Franco, Jose G. [UNESP] |
author2_role |
author author author author author author author author |
dc.contributor.none.fl_str_mv |
Ctr Human Reprod Prof Franco Jr Paulista Ctr Diag Res & Training Universidade Estadual Paulista (Unesp) Perola Byington Hosp |
dc.contributor.author.fl_str_mv |
Oliveira, Joao Batista A. [UNESP] Baruffi, Ricardo L. R. Petersen, Claudia G. [UNESP] Mauri, Ana L. Nascimento, Adriana M. Vagnini, Laura Ricci, Juliana Cavagna, Mario Franco, Jose G. [UNESP] |
dc.subject.por.fl_str_mv |
Ovarian response prediction index Individualised controlled ovarian stimulation Anti-Mullerian hormone Antral follicles Age |
topic |
Ovarian response prediction index Individualised controlled ovarian stimulation Anti-Mullerian hormone Antral follicles Age |
description |
Background: The objective was to present a new ovarian response prediction index (ORPI), which was based on anti-Mullerian hormone (AMH) levels, antral follicle count (AFC) and age, and to verify whether it could be a reliable predictor of the ovarian stimulation response.Methods: A total of 101 patients enrolled in the ICSI programme were included. The ORPI values were calculated by multiplying the AMH level (ng/ml) by the number of antral follicles (2-9 mm), and the result was divided by the age (years) of the patient (ORPI=(AMH x AFC)/Patient age).Results: The regression analysis demonstrated significant (P<0.0001) positive correlations between the ORPI and the total number of oocytes and of MII oocytes collected. The logistic regression revealed that the ORPI values were significantly associated with the likelihood of pregnancy (odds ratio (OR): 1.86; P=0.006) and collecting greater than or equal to 4 oocytes (OR: 49.25; P<0.0001), greater than or equal to 4 MII oocytes (OR: 6.26; P<0.0001) and greater than or equal to 15 oocytes (OR: 6.10; P<0.0001). Regarding the probability of collecting greater than or equal to 4 oocytes according to the ORPI value, the ROC curve showed an area under the curve (AUC) of 0.91 and an efficacy of 88% at a cut-off of 0.2. In relation to the probability of collecting greater than or equal to 4 MII oocytes according to the ORPI value, the ROC curve had an AUC of 0.84 and an efficacy of 81% at a cut-off of 0.3. The ROC curve for the probability of collecting greater than or equal to 15 oocytes resulted in an AUC of 0.89 and an efficacy of 82% at a cut-off of 0.9. Finally, regarding the probability of pregnancy occurrence according to the ORPI value, the ROC curve showed an AUC of 0.74 and an efficacy of 62% at a cut-off of 0.3.Conclusions: The ORPI exhibited an excellent ability to predict a low ovarian response and a good ability to predict a collection of greater than or equal to 4 MII oocytes, an excessive ovarian response and the occurrence of pregnancy in infertile women. The ORPI might be used to improve the cost-benefit ratio of ovarian stimulation regimens by guiding the selection of medications and by modulating the doses and regimens according to the actual needs of the patients. |
publishDate |
2012 |
dc.date.none.fl_str_mv |
2012-11-21 2014-05-20T13:35:40Z 2014-05-20T13:35:40Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1186/1477-7827-10-94 Reproductive Biology and Endocrinology. London: Biomed Central Ltd., v. 10, p. 11, 2012. 1477-7827 http://hdl.handle.net/11449/12277 10.1186/1477-7827-10-94 WOS:000314711300001 WOS000314711300001.pdf |
url |
http://dx.doi.org/10.1186/1477-7827-10-94 http://hdl.handle.net/11449/12277 |
identifier_str_mv |
Reproductive Biology and Endocrinology. London: Biomed Central Ltd., v. 10, p. 11, 2012. 1477-7827 10.1186/1477-7827-10-94 WOS:000314711300001 WOS000314711300001.pdf |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Reproductive Biology and Endocrinology 2.852 1,203 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
11 application/pdf |
dc.publisher.none.fl_str_mv |
Biomed Central Ltd. |
publisher.none.fl_str_mv |
Biomed Central Ltd. |
dc.source.none.fl_str_mv |
Web of Science reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
institution |
UNESP |
reponame_str |
Repositório Institucional da UNESP |
collection |
Repositório Institucional da UNESP |
repository.name.fl_str_mv |
Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
|
_version_ |
1808128210371608576 |