Evaluation of the utility of multiple endocrine and ultrasound measures of ovarian reserve in the prediction of cycle cancellation in a high-risk IVF population.
نویسندگان
چکیده
BACKGROUND Unexpectedly poor response leading to IVF cycle cancellation is a distressing treatment outcome. We have prospectively assessed several markers of ovarian reserve in a high risk IVF population to determine their utility in predicting IVF cycle cancellation. METHODS Eighty-four women at high risk of cycle cancellation due to raised FSH, previous poor response and/or age > or =40 years attending for high-dose short protocol IVF treatment had baseline measures of FSH, inhibin B, anti-Müllerian hormone (AMH), antral follicle count (AFC) and ovarian volume. A GnRH agonist was then administered and, 24 h later, estradiol (E(2)) and inhibin B measures were repeated. RESULTS Fifty-seven per cent of patients in this study had a poor response to stimulation, and 15% were cancelled. Using multivariate logistic regression, we found that day 3 inhibin B levels were the best predictor of cycle cancellation with an area under the receiver operating curve (ROC AUC) = 0.78 (P = 0.017). When only considering baseline variables, mean ovarian volume was the best predictor of cycle cancellation (ROC AUC = 0.78; P = 0.016). AMH concentrations were the best predictor of a poor response (P = 0.003), and AMH was also predictive of cycle cancellation (P = 0.007) with very little inter-cycle variability. None of the parameters studied were predictive of ongoing pregnancy. CONCLUSIONS This group of at-risk patients had a high rate of poor response to simulation and cancellation. Although several measures of ovarian reserve were able to predict cycle cancellation, none were able to predict pregnancy. AMH was predictive of both cycle cancellation and poor response with little inter-cycle variability.
منابع مشابه
The role of reduction of ovarian follicles in incidence of severe form of ovarian hyperstimulation dyndrome(OHSS)
Ovarian hyperstimulation dyndrome(OHSS) is one of the most serious complications of ovulation indution in infertile women particularly in poly cystic ovare (PCO).in recent years,in association with the increasing frequency of assisted reproductive technology(ART) usage and significant improvements in the treatment of infertility,this iatrogenic phenomenon is more prevalent.the aim of this clini...
متن کاملDexamethasone As a Supplement for Exogenous Gonadotropin to Improve Ovarian Response of Women over 35 Years Undergoing IVF/ICSI Cycles
Background With aging, the ovarian reserve is decreased and that is a major contributor to poor ovarian response to exogenous gonadotropins. The aim of the present study is to evaluate the role of Dexamethasone on ovarian response in infertile patients aged over 35 years undergoing IVF/ICSI cycles. MaterialsAndMethods In this triple blind placbo-control clinical trial study, a total of 72 infer...
متن کاملI-25: Management of Hydrosalpinx in ART
Hydrosalpinx, is one of the severe manifestations of tubal disease, is associated with significantly lower implantation and pregnancy rates, increased spontaneous abortion and ectopic pregnancy.This condition is usually due to PID but may also result from peritonitis of any cause or tubal damage from previous surgery.The mechanism for poor outcome in patients undergoing IVF is not yet clear. Ma...
متن کاملRescue In Vitro Maturation in Polycystic Ovarian Syndrome Patients Undergoing In Vitro Fertilization Treatment who Overrespond or Underrespond to Ovarian Stimulation: Is It A Viable Option? A Case Series Study
Background: This study intends to present the role of rescue in vitro maturation (IVM) in polycystic ovarian syndrome(PCOS) patients undergoing in vitro fertilization (IVF) treatment who have inappropriate responses to ovarianstimulation.Materials and Methods: This was a retrospective case series study of five PCOS patients undergoing IVF treatmentconsidered for cycle ca...
متن کاملI-38: Individualized Controlled Ovarian Stimulation: Matching Protocols with Patient Profile
The aim of all assisted reproductive techniques (ART) is a live birth of a single healthy baby. Many clinical and laboratory strategies can influence the ART clinical outcomes. In this lecture we try to explore the clinical and laboratory strategies to maximize success in ART. Three are the main issues: 1. optimize the number of oocyte retrieved with an individualized controlled ovarian superov...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Human reproduction
دوره 22 3 شماره
صفحات -
تاریخ انتشار 2007