Initial ovarian sensitivity index predicts embryo quality and pregnancy potential in the first days of controlled ovarian stimulation
Abstract Background To determine if a modified ovarian sensitivity index (MOSI), based on initial follicular measurements and the initial follicle-stimulating hormone (FSH) dose, can predict the production of high-quality embryos for successful implantation during in vitro fertilization (IVF). Metho...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-08-01
|
| Series: | Journal of Ovarian Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13048-020-00688-7 |
| _version_ | 1797964733061529600 |
|---|---|
| author | David Camargo-Mattos Uziel García Felipe Camargo-Diaz Ginna Ortiz Ivan Madrazo Esther Lopez-Bayghen |
| author_facet | David Camargo-Mattos Uziel García Felipe Camargo-Diaz Ginna Ortiz Ivan Madrazo Esther Lopez-Bayghen |
| author_sort | David Camargo-Mattos |
| collection | DOAJ |
| description | Abstract Background To determine if a modified ovarian sensitivity index (MOSI), based on initial follicular measurements and the initial follicle-stimulating hormone (FSH) dose, can predict the production of high-quality embryos for successful implantation during in vitro fertilization (IVF). Methods This study consisted of two phases: 1) a retrospective study and 2) a prospective observational study. For the first phase, 363 patients charts were reviewed, of which 283 had embryos transferred. All women underwent a standardized antagonist-based IVF protocol. At the first follow-up (Day 3/4), the number and size of the follicles were determined. MOSI was calculated as ln (number follicles (≥6 mm) × 1000 / FSH initial dose). Afterward, the number and quality of the ova, embryo development, and the number and quality of the blastocysts were determined. Embryo implantation was confirmed by β-hCG. For the second phase, 337 IVF cycles were followed to determine MOSI’s accuracy. Results MOSI could predict the production of ≥4 high-quality embryos by Day 2 (AUC = 0.69, 95%CI:0.63–0.75), ≥2 blastocysts (AUC = 0.74, 95%CI:0.68–0.79), and ≥ 35% rate of blastocyst formation (AUC = 0.65, 95%CI:0.58–0.72). Using linear regression, MOSI was highly associated with the number of ova captured (β = 5.15), MII oocytes (β = 4.31), embryos produced (β = 2.90), high-quality embryos (β = 0.98), and the blastocyst formation rate (β = 0.06, p < 0.01). Using logistic regression, MOSI was highly associated with achieving ≥4 high-quality embryos (odds ratio = 2.80, 95%CI:1.90–4.13), ≥2 blastocysts (odds ratio = 3.40, 95%CI:2.33–4.95), and ≥ 35% blastocysts formation rate (odds ratio = 1.96, 95%CI:1.31–2.92). This effect was independent of age, BMI, and antral follicle count. For implantation, MOSI was significantly associated with successful implantation (odds ratio = 1.79, 95%CI:1.25–2.57). For the prospective study, MOSI was highly accurate at predicting ≥6 high-quality embryos on Day 2 (accuracy = 68.5%), ≥6 blastocysts (accuracy = 68.0%), and a blastocyst formation rate of ≥35% (accuracy = 61.4%). Conclusion MOSI was highly correlated with key IVF parameters that are associated with achieved pregnancy. Using this index with antagonist cycles, clinicians may opt to stop an IVF cycle, under the assumption that the cycle will fail to produce good blastocysts, preventing wasting the patient’s resources and time. |
| first_indexed | 2024-04-11T01:49:38Z |
| format | Article |
| id | doaj.art-37f3ec005ac54eb2a87f8a384b84166d |
| institution | Directory Open Access Journal |
| issn | 1757-2215 |
| language | English |
| last_indexed | 2024-04-11T01:49:38Z |
| publishDate | 2020-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Ovarian Research |
| spelling | doaj.art-37f3ec005ac54eb2a87f8a384b84166d2023-01-03T06:58:16ZengBMCJournal of Ovarian Research1757-22152020-08-0113111010.1186/s13048-020-00688-7Initial ovarian sensitivity index predicts embryo quality and pregnancy potential in the first days of controlled ovarian stimulationDavid Camargo-Mattos0Uziel García1Felipe Camargo-Diaz2Ginna Ortiz3Ivan Madrazo4Esther Lopez-Bayghen5Clinical Research, Instituto de Infertilidad y Genética México SC, IngenesClinical Research, Instituto de Infertilidad y Genética México SC, IngenesClinical Research, Instituto de Infertilidad y Genética México SC, IngenesClinical Research, Instituto de Infertilidad y Genética México SC, IngenesClinical Research, Instituto de Infertilidad y Genética México SC, IngenesDepartamento de Toxicología, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV-IPN)Abstract Background To determine if a modified ovarian sensitivity index (MOSI), based on initial follicular measurements and the initial follicle-stimulating hormone (FSH) dose, can predict the production of high-quality embryos for successful implantation during in vitro fertilization (IVF). Methods This study consisted of two phases: 1) a retrospective study and 2) a prospective observational study. For the first phase, 363 patients charts were reviewed, of which 283 had embryos transferred. All women underwent a standardized antagonist-based IVF protocol. At the first follow-up (Day 3/4), the number and size of the follicles were determined. MOSI was calculated as ln (number follicles (≥6 mm) × 1000 / FSH initial dose). Afterward, the number and quality of the ova, embryo development, and the number and quality of the blastocysts were determined. Embryo implantation was confirmed by β-hCG. For the second phase, 337 IVF cycles were followed to determine MOSI’s accuracy. Results MOSI could predict the production of ≥4 high-quality embryos by Day 2 (AUC = 0.69, 95%CI:0.63–0.75), ≥2 blastocysts (AUC = 0.74, 95%CI:0.68–0.79), and ≥ 35% rate of blastocyst formation (AUC = 0.65, 95%CI:0.58–0.72). Using linear regression, MOSI was highly associated with the number of ova captured (β = 5.15), MII oocytes (β = 4.31), embryos produced (β = 2.90), high-quality embryos (β = 0.98), and the blastocyst formation rate (β = 0.06, p < 0.01). Using logistic regression, MOSI was highly associated with achieving ≥4 high-quality embryos (odds ratio = 2.80, 95%CI:1.90–4.13), ≥2 blastocysts (odds ratio = 3.40, 95%CI:2.33–4.95), and ≥ 35% blastocysts formation rate (odds ratio = 1.96, 95%CI:1.31–2.92). This effect was independent of age, BMI, and antral follicle count. For implantation, MOSI was significantly associated with successful implantation (odds ratio = 1.79, 95%CI:1.25–2.57). For the prospective study, MOSI was highly accurate at predicting ≥6 high-quality embryos on Day 2 (accuracy = 68.5%), ≥6 blastocysts (accuracy = 68.0%), and a blastocyst formation rate of ≥35% (accuracy = 61.4%). Conclusion MOSI was highly correlated with key IVF parameters that are associated with achieved pregnancy. Using this index with antagonist cycles, clinicians may opt to stop an IVF cycle, under the assumption that the cycle will fail to produce good blastocysts, preventing wasting the patient’s resources and time.http://link.springer.com/article/10.1186/s13048-020-00688-7Poor ovarian responseOvarian sensitivity indexAntral follicle countIn vitro fertilizationFollicle-stimulating hormone |
| spellingShingle | David Camargo-Mattos Uziel García Felipe Camargo-Diaz Ginna Ortiz Ivan Madrazo Esther Lopez-Bayghen Initial ovarian sensitivity index predicts embryo quality and pregnancy potential in the first days of controlled ovarian stimulation Journal of Ovarian Research Poor ovarian response Ovarian sensitivity index Antral follicle count In vitro fertilization Follicle-stimulating hormone |
| title | Initial ovarian sensitivity index predicts embryo quality and pregnancy potential in the first days of controlled ovarian stimulation |
| title_full | Initial ovarian sensitivity index predicts embryo quality and pregnancy potential in the first days of controlled ovarian stimulation |
| title_fullStr | Initial ovarian sensitivity index predicts embryo quality and pregnancy potential in the first days of controlled ovarian stimulation |
| title_full_unstemmed | Initial ovarian sensitivity index predicts embryo quality and pregnancy potential in the first days of controlled ovarian stimulation |
| title_short | Initial ovarian sensitivity index predicts embryo quality and pregnancy potential in the first days of controlled ovarian stimulation |
| title_sort | initial ovarian sensitivity index predicts embryo quality and pregnancy potential in the first days of controlled ovarian stimulation |
| topic | Poor ovarian response Ovarian sensitivity index Antral follicle count In vitro fertilization Follicle-stimulating hormone |
| url | http://link.springer.com/article/10.1186/s13048-020-00688-7 |
| work_keys_str_mv | AT davidcamargomattos initialovariansensitivityindexpredictsembryoqualityandpregnancypotentialinthefirstdaysofcontrolledovarianstimulation AT uzielgarcia initialovariansensitivityindexpredictsembryoqualityandpregnancypotentialinthefirstdaysofcontrolledovarianstimulation AT felipecamargodiaz initialovariansensitivityindexpredictsembryoqualityandpregnancypotentialinthefirstdaysofcontrolledovarianstimulation AT ginnaortiz initialovariansensitivityindexpredictsembryoqualityandpregnancypotentialinthefirstdaysofcontrolledovarianstimulation AT ivanmadrazo initialovariansensitivityindexpredictsembryoqualityandpregnancypotentialinthefirstdaysofcontrolledovarianstimulation AT estherlopezbayghen initialovariansensitivityindexpredictsembryoqualityandpregnancypotentialinthefirstdaysofcontrolledovarianstimulation |