Índice preditor de reserva ovariana (ORPI) para controle de estimulação ovariana individualizado
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Data
2013-05-03
Autores
Oliveira, Joao Batista A. [UNESP]
Petersen, Claudia G. [UNESP]
Mauri, Ana L.
Cavagna, Mario
Baruffi, Ricardo L R.
Franco Junior, Jose Gonçalves [UNESP]
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Resumo
Objective: to expand the evaluation of a new ovarian response prediction index (ORPI), which was based on the AMH, AFC and age, and to verify its reability as a predictor of ovarian response to stimulation in assisted reproductive technology (ART) cycles. Methods: A total of 129 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 × AFC)/Patient age). Results: Spearman's test revealed significant correlations (P<0.0001) between the ORPI and the number of oocytes collected and the number of follicles. Logistic regression revealed that ORPI values were significantly associated with the likelihood of collecting ≥4 oocytes (OR=45.56), ≥4 MII oocytes (OR=6.01) and ≥15 oocytes (OR=6.15; P<0.0001). Based on the ROC curves, the ORPI accurately predicted a low ovarian response (<4 oocytes retrieved; area under the curve (AUC):0.91), collection of ≥4 MII oocytes (AUC:0.85) and an excessive ovarian response (≥15 oocytes retrieved; AUC:0.89). Conclusions: The ORPI exhibited an excellent ability to predict a low ovarian response and a good ability to predict a collection of ≥ 4 MII oocytes, an excessive ovarian response. 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. © Todos os direitos reservados a SBRA - Sociedade Brasileira de Reprodução Assistida.
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Palavras-chave
Age, Anti-Mullerian hormone, Antral follicles, Individualized controlled ovarian stimulation, Ovarian response prediction index, cetrorelix, chorionic gonadotropin, leuprorelin, luteinizing hormone, Muellerian inhibiting factor, recombinant follitropin, adult, age, cost benefit analysis, drug dose increase, female, human, major clinical study, named inventories, questionnaires and rating scales, oocyte, ovarian response prediction index, ovary follicle, ovary function, transvaginal echography
Como citar
Jornal Brasileiro de Reproducao Assistida, v. 17, n. 2, p. 77-83, 2013.