scholarly journals The evaluative effectiveness of a combined index exceeded that of a single variable for the ovarian reserve and response of infertile women

2019 ◽  
Author(s):  
Shan-Jie Zhou ◽  
Ming-Jia Zhao ◽  
Cui Li ◽  
Xing Su
Keyword(s):  
Ovarian Reserve ◽  
Predictive Accuracy ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Ovarian Response ◽  
Antral Follicle ◽  
The Other ◽  
Single Variable ◽  
Infertile Women ◽  
Better Than

Abstract Aim of the present study was to explore the evaluative effectiveness of age, ovarian volume, antral follicle count (AFC), serum follicle-stimulating hormone (FSH), anti-Müllerian hormone (AMH), FSH/LH ratio and ovarian response prediction index (ORPI) to determine which could most advantageously assess ovarian reserve and response.Methods This research enrolled 319 consecutive infertile women who had undergone IVF-ET/ICSI treatments. Abovementioned variables were measured and calculated. Receiver Operating Characteristic Curve analysis was used to analyze the predictive accuracy of variables and to calculate cut-off values and corresponding sensitivity and specificity.Results Our study revealed that the significant variables for evaluating a decline in ovarian reserve include age, total volume of bilateral ovary, FSH, and ORPI. Moreover, the area under the curve (AUC) of ORPI was higher than other three variables (AUC = 0.903), and the cut-off value of ORPI was 0.245 (sensitivity 90.1%, specificity 73.9%). The significant variables forecasting excessive ovarian response were age, AFC, AMH, ORPI, FSH and FSH/LH ratio, and the significant variables forecasting low ovarian response were AMH and FSH/LH ratio. ORPI and FSH/LH ratio presented better effectiveness in evaluating ovarian response. When they were used to predict excessive response, the cut-off values of ORPI and FSH/LH ratio was 0.886 (sensitivity 84.7%, specificity 67.3%) and 1.753 (sensitivity 56.2%, specificity 67.6%), respectively. When used to predict low response, the cut-off value of FSH/LH ratio was 2.983 (sensitivity 75.0%, specificity 83.8%).Conclusions ORPI performed better than did the other variables in evaluating ovarian reserve and predicting excessive ovarian response, and the FSH/LH ratio performed better than did the other variables in predicting low ovarian response. Consequently, we agreed that the evaluative effectiveness of a combined index exceeded that of a single variable for evaluating the ovarian reserve and response of infertile women.

scholarly journals The Evaluative Effectiveness of a Combined Index Exceeded That of a Single Variable for the Ovarian Reserve and Response of Infertile Women

2019 ◽  
Author(s):  
Shan-Jie Zhou ◽  
Ming-Jia Zhao ◽  
Cui Li ◽  
Xing Su
Keyword(s):  
Ovarian Reserve ◽  
Predictive Accuracy ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Ovarian Response ◽  
Antral Follicle ◽  
The Other ◽  
Single Variable ◽  
Infertile Women ◽  
Better Than

Abstract Background: Aim of the present study was to explore the evaluative effectiveness of age, ovarian volume, antral follicle count (AFC), serum follicle-stimulating hormone (FSH), anti-Müllerian hormone (AMH), FSH/LH ratio and ovarian response prediction index (ORPI) to determine which could most advantageously assess ovarian reserve and response. Methods: This research enrolled 319 consecutive infertile women who had undergone IVF-ET/ICSI treatments. Abovementioned variables were measured and calculated. Receiver Operating Characteristic Curve analysis was used to analyze the predictive accuracy of variables and to calculate cut-off values and corresponding sensitivity and specificity. Results: Our study revealed that the significant variables for evaluating a decline in ovarian reserve include age, total volume of bilateral ovary, FSH, and ORPI. Moreover, the area under the curve (AUC) of ORPI was higher than other three variables (AUC = 0.903), and the cut-off value of ORPI was 0.245 (sensitivity 90.1%, specificity 73.9%). The significant variables forecasting excessive ovarian response were age, AFC, AMH, ORPI, FSH and FSH/LH ratio, and the significant variables forecasting low ovarian response were AMH and FSH/LH ratio. ORPI and FSH/LH ratio presented better effectiveness in evaluating ovarian response. When they were used to predict excessive response, the cut-off values of ORPI and FSH/LH ratio was 0.886 (sensitivity 84.7%, specificity 67.3%) and 1.753 (sensitivity 56.2%, specificity 67.6%), respectively. When used to predict low response, the cut-off value of FSH/LH ratio was 2.983 (sensitivity 75.0%, specificity 83.8%). Conclusions: ORPI performed better than did the other variables in evaluating ovarian reserve and predicting excessive ovarian response, and the FSH/LH ratio performed better than did the other variables in predicting low ovarian response. Consequently, we agreed that the evaluative effectiveness of a combined index exceeded that of a single variable for evaluating the ovarian reserve and response of infertile women.

Antral Follicle Diameter Variance Within Each Ovary May Be A Predictor For Poor Response In Cases With Normal Ovarian Reserve

2018 ◽  
Vol 126 (08) ◽  
pp. 521-527
Author(s):  
Ilhan Sanverdi ◽  
Enis Ozkaya ◽  
Suna Kucur ◽  
Dilsat Bilen ◽  
Meryem Eken ◽  
...  
Keyword(s):  
Ovarian Reserve ◽  
Poor Response ◽  
Ovarian Response ◽  
Antral Follicle ◽  
Multivariate Regression Analysis ◽  
Antral Follicle Count ◽  
Estradiol Level ◽  
Poor Ovarian Response ◽  
Follicle Diameter ◽  
The Right

Abstract Objectives To determine the predictive value of antral follicle diameter variance within each ovary for ovarian response in cases with normal ovarian reserve tests. Methods This is a prospective observational study. One hundred and thirty nine infertile women who underwent ART in IVF-ICSI unit of Zeynep Kamil women and children’s Health Training and research hospital between January 2017 to June 2017 were recruited. Blood samples were collected on day 2/day 3 for assessment of serum FSH and estradiol. Trans-vaginal sonography was done for antral follicle count. During antral follicle count, in order to determine antral follicle diameter variance, diameters of the largest and smallest follicles were recorded. Variance was calculated by subtracting the smallest diameter from the largest one. Following ovarian stimulation with antagonist protocol, poor response was determined in cases with total oocyte number≤3. Ovarian reserve tests and antral follicle diameter variance were utilized to predict cases with poor response in women with normal ovarian reserve. Results Antral follicle diameter variance both in right (AUC=0.737, P<0.001) and left (AUC=0.651, P<0.05) ovaries significantly predicted poor ovarian response. Variance>3.5 mm was found to have 75% sensitivity to predict poor response. Basal serum FSH with estradiol levels and AFC failed to predict poor response (P>0.05). Other significant predictors for poor response were day 5 estradiol level and estradiol level at trigger day (P<0.05). In multivariate regression analysis, both AFC and antral follicle diameter variance in the right ovary were found to be significantly associated with clinical pregnancy, on the other hand peak estradiol concentration and antral follicle diameter variance in the right ovary were significantly associated with poor response. Conclusion Antral follicle diameter variance may be utilized to predict poor ovarian response in cases with normal ovarian reserve.

Combination of tumour markers CEA and CA19-9 improves the prognostic prediction in patients with pancreatic cancer

2015 ◽  
Vol 68 (6) ◽  
pp. 427-433 ◽  
Author(s):  
Daniel Reitz ◽  
Armin Gerger ◽  
Julia Seidel ◽  
Peter Kornprat ◽  
Hellmut Samonigg ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Predictive Accuracy ◽  
Area Under The Curve ◽  
Carbohydrate Antigen ◽  
Tumour Markers ◽  
Cancer Specific Survival ◽  
Receiver Operating Characteristic Curves ◽  
Prognostic Prediction ◽  
Medical University ◽  
Better Than

AimsTumour markers including carcinoembryonic antigen (CEA) or carbohydrate antigen 19-9 (CA19-9) are frequently determined at the time of diagnosis in patients with pancreatic cancer. Several studies indicate a prognostic relevance of these markers in pancreatic cancer, but space for improvement with regard to the predictive accuracy and ability is given. In this work, the main focus is on mathematical combinations of these two tumour markers in order to validate an improvement of prognostic test results in terms of sensitivity and specificity.MethodsThis retrospective study includes 393 patients with pancreatic cancer, who were treated between the years 2005 and 2012 at the Division of Oncology, Medical University of Graz, Austria. The goal of this study was to explore whether an appropriate combination of two tumour markers leads to a statistically significant improvement of the prognostic prediction.ResultsReceiver operating characteristic curves comparison analyses with the classification variable cancer-specific survival showed that the mathematical product of two tumour markers (TMproduct= (CEA×CA19-9); area under the curve (AUC)=0.727; 95% CI 0.680 to 0.770) is significantly better than CEA alone (AUC=0.644; 95% CI 0.594 to 0.691; p=0.003) but not significant compared with CA19-9 (AUC=0.710; 95% CI 0.662 to 0.754; p=0.1215). A linear combination of CEA and CA19-9 (TMlinear=(85×CEA+CA19-9); AUC=0.748; 95% CI 0.702 to 0.790) is significantly better than CEA (p<0.0001) as well as CA19-9 alone (p=0.0304).ConclusionsMathematical combinations of pretherapeutic tumour markers CEA and CA19-9 are feasible and can significantly improve the prognostic prediction in patients with pancreatic cancer.

scholarly journals Correlation Between Follicle Stimulating Hormone, Anti-Müllerian Hormone and Antral Follicle Count with Different Age Groups in Infertile Women

2021 ◽  
Vol 20 (1) ◽  
pp. 22-27
Author(s):  
Juthi Bhowmik ◽  
Parveen Fatima ◽  
Jesmine Banu ◽  
Farzana Deeba ◽  
Sheuli Chowdhury ◽  
...  
Keyword(s):  
Negative Correlation ◽  
Ovarian Reserve ◽  
Follicle Stimulating Hormone ◽  
Age Groups ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Age Group ◽  
Infertile Women ◽  
Group A ◽  
Study Population

Background: Reduced ovarian reserve predicts poor ovarian response and poor suc-- cess rates in infertile women who undergo Assisted Reproductive Technology (ART). Ovarian reserve decreases with age but the rate of decline varies from one woman to another. Follicle Stimulating Hormone (FSH) Anti-Müllerian Hormone (AMH) and antral follicle count (AFC) represent the three most frequently utilized laboratory tests in determining Ovarian Reserve (OR). To determine correlation between FSH, AMH and AFC in infertile female. Materials and methods: It was an observational (Cross sectional) study. This study was done in the Department of Reproductive Endocrinology and Infertility, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, between July 2018 to June 2019. The study population consisted of all the diagnosed female infertility patients of reproductive age. The women attending the study center during study period having primary or secondary infertility was considered as study population. They were divided in 4 age groups 21-25, 26-30, 31-35 yrs and 36-40 yrs years. Data was collected using a structured questionnaire following physical & lab examination. For D2 FSH level fasting blood was collected on D2/3 of menstrual cycle, serum FSH level was measured by ADVIA Centraur(R) XP immunoassay system. For S. AMH level blood sample was collected on 2nd day of cycle and measured by BECKMAN COULTER machine using Chemiluminescent Immunoassay method. For AFC count TVS was done on D2-5 of cycle using KONTRON medical USG machine. Collected data were classified, edited, coded and entered into the computer for statistical analysis by using SPSS version 23. Results: Out of 74 patients the mean age was found 32.6±5.5 years. Serum FSH, AMH and AFC were significantly associated with different age group. A negative correlation was found between serum FSH and serum AMH in all age group. But strong correlation found in age group 31-35 yrs and in 36-40 years age group. A negative correlation was found between serum FSH and total AFC in age group 26- 30 years, 31-35 years and 36-40 years respectively. A positive correlation was found between serum AMH and total AFC in all age group but most strong in age group 31-35 years. In multivariate logistic regression analysis serum AMH (<1.0 ng/ml) and total AFC (<5 number) were found to be significantly associated with age group >35 years patients. Conclusion: In all age grqoup, FSH, AMH and AFC correlates but it is more pronounced in advanced age that means >35 years age group. Chatt Maa Shi Hosp Med Coll J; Vol.20 (1); January 2021; Page 22-27

scholarly journals Diminished Ovarian Reserve, Causes, Assessment and Management

2013 ◽  
Vol 4 (2) ◽  
pp. 45-55 ◽  
Author(s):  
Mala Arora ◽  
Mandeep Kaur
Keyword(s):  
Ovarian Reserve ◽  
Treatment Options ◽  
Poor Response ◽  
Ovarian Response ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Diminished Ovarian Reserve ◽  
Assisted Hatching ◽  
Ovum Donation ◽  
Antagonist Protocol

ABSTRACT Diminished ovarian reserve predicts diminished ovarian response to stimulation but does not predict cycle fecundity. It has been recently defined by ESHRE, the Bologna's criteria, according to which at least two of the following three features should be present: (1) Age >40 years/any other risk factor for DOR, (2) abnormal ovarian reserve test, i.e. antral follicle count, AMH, (3) poor ovarian response in a previous stimulated cycle, i.e. less than three follicles after standard gonadotropin stimulation. Poor response to maximal stimulation on two previous occasions also defines DOR. The treatment options are limited. Avoiding the GnRH agonist long protocol and stimulation with microdose flare or antagonist protocol yields better results. Adjuvant therapy with LH, DHEAS and growth hormone shows some benefit in improving the oocyte yield. It is advisable to perform ICSI for all obtained oocytes and some advocate assisted hatching. Pregnancy rates are, however, poor and often these patients require ovum donation. Developing tests that will diagnose DOR in a low-risk population will allow women to plan their reproductive careers early. How to cite this article Kaur M, Arora M. Diminished Ovarian Reserve, Causes, Assessment and Management. Int J Infertility Fetal Med 2013;4(2):45-55.

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