电邮这篇文章 Main characteristics of IVF / ICSI protocols in patients with suboptimal response to controlled ovarian stimulation
- 作者: Tuan N.C.1, Dzhemlikhanova L.K.1,2, Makhmadaliyeva M.R.2, Kogan I.Y.1,2, Niauri D.A.1,2, Krikheli I.O.2, Obyedkova K.V.2, Safaryan G.K.1, Mekina I.D.2, Lesik E.A.2, Ishchuk M.A.2, Gzgzyan A.M.1,2
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隶属关系:
- Saint Petersburg State University
- The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
- 期: 卷 70, 编号 1 (2021)
- 页面: 109-118
- 栏目: Original study articles
- URL: https://ogarev-online.ru/jowd/article/view/55264
- DOI: https://doi.org/10.17816/JOWD55264
- ID: 55264
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HYPOTHESIS/AIMS OF STUDY: According to the number of oocytes retrieved in IVF/ICSI protocols, the ovarian response to controlled ovarian stimulation is divided into: poor (0–3 oocytes), suboptimal (4–9 oocytes), normal (10–15 oocytes) and excessive (>15 oocytes) response. However, the effectiveness of IVF / ICSI programs in women with a suboptimal response is poorly understood, since this cohort of patients is often fallen into the category of women with a normal response. The aim of this study was to determine the main characteristics of IVF / ICSI programs in patients with suboptimal response to be further compared to those in women with normal response to controlled ovarian stimulation.
STUDY DESIGN, MATERIALS AND METHODS: This retrospective study included 568 patients: 470 women with suboptimal response and 98 women with normal response to controlled ovarian stimulation. The comparative analysis comprised clinical and anamnestic data, as well as the main characteristics of assisted reproductive technology programs in the selected clinical groups.
RESULTS: It was found that patients with suboptimal response to controlled ovarian stimulation had significantly more frequent history of pelvic surgery (71.3 % vs. 55.1 %; p < 0.01) and pelvic inflammatory diseases (70.9% vs. 60.2%; p < 0.05). Parameters of ovarian reserve (serum anti-Müllerian hormone level and antral follicle count) in women with suboptimal response were significantly lower (p < 0.001). In addition, the number of mature oocytes, 2PN zygotes, good quality embryos (p < 0.001), as well as the clinical pregnancy rate in women with suboptimal response were found to be significantly lower than in patients with normal response to controlled ovarian stimulation (27.2% vs. 41.7%; p < 0.01). It was noted that concomitant uterine fibroids enhanced the negative impact on the effectiveness of IVF / ICSI programs in women with suboptimal response to controlled ovarian stimulation (OR = 0.5; 95% CI: 0.3–0.9; p = 0.03). ROC analysis identified predictors of suboptimal response to controlled ovarian stimulation, such as serum anti-Müllerian hormone level (AUC = 0.80) with the cut-off value of ≤2.57 ng / ml (sensitivity 74%, specificity 75%) and antral follicle count (AUC = 0.90) with the cut-off value of ≤10 follicles (sensitivity 80%, specificity 94%).
CONCLUSION: In women with suboptimal response to controlled ovarian stimulation, IVF / ICSI success rates are significantly reduced when compared to those in women with normal response. Concomitant uterine fibroids may further decrease the effectiveness of IVF / ICSI protocols in patients with suboptimal response. Predictors of suboptimal response include the serum anti-Müllerian hormone level and antral follicle count.
作者简介
Nguyen Tuan
Saint Petersburg State University
编辑信件的主要联系方式.
Email: dr.tuan99999@gmail.com
ORCID iD: 0000-0002-4665-9025
MD, Postgraduate Student
俄罗斯联邦, Saint PetersburgLyailya Dzhemlikhanova
Saint Petersburg State University; The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: dzhemlikhanova_l@mail.ru
ORCID iD: 0000-0001-6842-4430
SPIN 代码: 1691-6559
MD, PhD, Associate Professor
俄罗斯联邦, Saint PetersburgManizha Makhmadaliyeva
The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: 2563737@mail.ru
ORCID iD: 0000-0002-9578-8931
俄罗斯联邦, Saint Petersburg
Igor Kogan
Saint Petersburg State University; The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: ikogan@mail.ru
ORCID iD: 0000-0002-7351-6900
SPIN 代码: 6572-6450
Scopus 作者 ID: 56895765600
MD, PhD, DSci (Medicine), Professor, Corresponding Member of the Russian Academy of Sciences
俄罗斯联邦, Saint PetersburgDariko Niauri
Saint Petersburg State University; The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: d.niauri@mail.ru
ORCID iD: 0000-0003-1556-248X
SPIN 代码: 4384-9785
MD, PhD, DSci (Medicine), Professor
俄罗斯联邦, Saint PetersburgInna Krikheli
The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: ikrikhely@gmail.com
ORCID iD: 0000-0002-5439-1727
SPIN 代码: 7356-6189
MD, PhD
俄罗斯联邦, Saint PetersburgKsenia Obyedkova
The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: obedkova_ks@mail.ru
ORCID iD: 0000-0002-2056-7907
MD, PhD
俄罗斯联邦, Saint PetersburgGalina Safaryan
Saint Petersburg State University
Email: Galasaf07@gmail.com
ORCID iD: 0000-0001-5988-323X
MD, Post-Graduate Student
俄罗斯联邦, Saint PetersburgIrina Mekina
The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: iagmail@ott.ru
ORCID iD: 0000-0002-0813-5845
SPIN 代码: 4682-8590
PhD
俄罗斯联邦, Saint PetersburgElena Lesik
The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: lesike@yandex.ru
ORCID iD: 0000-0003-1611-6318
PhD
俄罗斯联邦, Saint PetersburgMaria Ishchuk
The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: mashamazilina@gmail.com
ORCID iD: 0000-0002-4443-4287
俄罗斯联邦, Saint Petersburg
Alexander Gzgzyan
Saint Petersburg State University; The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: agzgzyan@gmail.com
ORCID iD: 0000-0003-3917-9493
SPIN 代码: 6412-4801
MD, PhD, DSci (Medicine), Professor
俄罗斯联邦, Saint Petersburg参考
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