A new ovarian response prediction index (ORPI): implications for individualised controlled ovarian stimulation

Detalhes bibliográficos
Autor(a) principal: Oliveira, Joao Batista A. [UNESP]
Data de Publicação: 2012
Outros Autores: Baruffi, Ricardo L. R., Petersen, Claudia G. [UNESP], Mauri, Ana L., Nascimento, Adriana M., Vagnini, Laura, Ricci, Juliana, Cavagna, Mario, Franco, Jose G. [UNESP]
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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spelling 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
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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
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