Determinants of Severe Late Ovarian Hyperstimulation Syndrome in Fresh Embryo Transfer Cycles Based on Integration of Decision Tree Classification and Conditional Logistic Regression
Background: To explore possible predictors of severe late ovarian hyperstimulation syndrome (SL-OHSS) in fresh embryo transfer cycles. Methods: We conducted a historical cohort study in a Chinese tertiary hospital from January 2017 to December 2019, with a total of 6931 women who had the first fresh...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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IMR Press
2023-02-01
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| Series: | Clinical and Experimental Obstetrics & Gynecology |
| Subjects: | |
| Online Access: | https://www.imrpress.com/journal/CEOG/50/2/10.31083/j.ceog5002036 |
| _version_ | 1797893241622757376 |
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| author | Lijun Lin Xuelian Yuan Xiaohong Li Sarah Hunt Ge Chen Shan Luo Xiaohong Li |
| author_facet | Lijun Lin Xuelian Yuan Xiaohong Li Sarah Hunt Ge Chen Shan Luo Xiaohong Li |
| author_sort | Lijun Lin |
| collection | DOAJ |
| description | Background: To explore possible predictors of severe late ovarian hyperstimulation syndrome (SL-OHSS) in fresh embryo transfer cycles. Methods: We conducted a historical cohort study in a Chinese tertiary hospital from January 2017 to December 2019, with a total of 6931 women who had the first fresh embryo transfer included. SL-OHSS was defined as severe symptoms of OHSS occurring 12–17 days after ovulation triggering. Possible determinants of the occurrence of SL-OHSS were identified by a detection decision tree, effects of which were estimated by conditional logistic regression and restricted cubic spline. Results: Elevated estradiol (E2) on the day of ovulation triggering and elevated Anti-Mullerian hormone (AMH) were associated with an increased risk of SL-OHSS (p < 0.001). Women with an E2 on trigger day of ≥3320.2 pg/mL (odds ratio (OR): 2.20; 95% confidence interval (CI): 1.03–4.68), or with an E2 on trigger day of <3320.2 pg/mL and an AMH of ≥4.62 ng/mL (OR: 5.44; 95% CI: 2.29–12.90), had an increased risk of SL-OHSS compared to their counterparts. Women with E2 on trigger day of >3320.2 pg/mL and AMH of >4.62 ng/mL had the highest risk of SL-OHSS (OR: 13.20; 95% CI: 3.87–45.02) when compared with E2 on trigger day of ≤3320.2 pg/mL and AMH of ≤4.62 ng/mL. This association was not linear. Conclusions: Serum E2 concentration on trigger day and AMH levels at baseline may predict SL-OHSS occurrence in fresh embryo transfer cycles. These biomarkers may be valuable in determining the optimum transfer strategy to limit the occurrence of SL-OHSS. |
| first_indexed | 2024-04-10T06:49:45Z |
| format | Article |
| id | doaj.art-aa641a66868840fba6c4c513f513b6e5 |
| institution | Directory Open Access Journal |
| issn | 0390-6663 |
| language | English |
| last_indexed | 2024-04-10T06:49:45Z |
| publishDate | 2023-02-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Clinical and Experimental Obstetrics & Gynecology |
| spelling | doaj.art-aa641a66868840fba6c4c513f513b6e52023-02-28T08:29:05ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632023-02-015023610.31083/j.ceog5002036S0390-6663(22)01995-9Determinants of Severe Late Ovarian Hyperstimulation Syndrome in Fresh Embryo Transfer Cycles Based on Integration of Decision Tree Classification and Conditional Logistic RegressionLijun Lin0Xuelian Yuan1Xiaohong Li2Sarah Hunt3Ge Chen4Shan Luo5Xiaohong Li6Center for Reproductive Medicine, Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, 610041 Chengdu, Sichuan, ChinaNational Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, 610041 Chengdu, Sichuan, ChinaNational Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, 610041 Chengdu, Sichuan, ChinaDepartment of Obstetrics and Gynecology, Monash University, 3168 Clayton, AustraliaCenter for Reproductive Medicine, Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, 610041 Chengdu, Sichuan, ChinaCenter for Reproductive Medicine, Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, 610041 Chengdu, Sichuan, ChinaCenter for Reproductive Medicine, Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, 610041 Chengdu, Sichuan, ChinaBackground: To explore possible predictors of severe late ovarian hyperstimulation syndrome (SL-OHSS) in fresh embryo transfer cycles. Methods: We conducted a historical cohort study in a Chinese tertiary hospital from January 2017 to December 2019, with a total of 6931 women who had the first fresh embryo transfer included. SL-OHSS was defined as severe symptoms of OHSS occurring 12–17 days after ovulation triggering. Possible determinants of the occurrence of SL-OHSS were identified by a detection decision tree, effects of which were estimated by conditional logistic regression and restricted cubic spline. Results: Elevated estradiol (E2) on the day of ovulation triggering and elevated Anti-Mullerian hormone (AMH) were associated with an increased risk of SL-OHSS (p < 0.001). Women with an E2 on trigger day of ≥3320.2 pg/mL (odds ratio (OR): 2.20; 95% confidence interval (CI): 1.03–4.68), or with an E2 on trigger day of <3320.2 pg/mL and an AMH of ≥4.62 ng/mL (OR: 5.44; 95% CI: 2.29–12.90), had an increased risk of SL-OHSS compared to their counterparts. Women with E2 on trigger day of >3320.2 pg/mL and AMH of >4.62 ng/mL had the highest risk of SL-OHSS (OR: 13.20; 95% CI: 3.87–45.02) when compared with E2 on trigger day of ≤3320.2 pg/mL and AMH of ≤4.62 ng/mL. This association was not linear. Conclusions: Serum E2 concentration on trigger day and AMH levels at baseline may predict SL-OHSS occurrence in fresh embryo transfer cycles. These biomarkers may be valuable in determining the optimum transfer strategy to limit the occurrence of SL-OHSS.https://www.imrpress.com/journal/CEOG/50/2/10.31083/j.ceog5002036ovarian hyperstimulation syndromefresh embryo transferestradiolanti-mullerian hormonedecision tree model |
| spellingShingle | Lijun Lin Xuelian Yuan Xiaohong Li Sarah Hunt Ge Chen Shan Luo Xiaohong Li Determinants of Severe Late Ovarian Hyperstimulation Syndrome in Fresh Embryo Transfer Cycles Based on Integration of Decision Tree Classification and Conditional Logistic Regression Clinical and Experimental Obstetrics & Gynecology ovarian hyperstimulation syndrome fresh embryo transfer estradiol anti-mullerian hormone decision tree model |
| title | Determinants of Severe Late Ovarian Hyperstimulation Syndrome in Fresh Embryo Transfer Cycles Based on Integration of Decision Tree Classification and Conditional Logistic Regression |
| title_full | Determinants of Severe Late Ovarian Hyperstimulation Syndrome in Fresh Embryo Transfer Cycles Based on Integration of Decision Tree Classification and Conditional Logistic Regression |
| title_fullStr | Determinants of Severe Late Ovarian Hyperstimulation Syndrome in Fresh Embryo Transfer Cycles Based on Integration of Decision Tree Classification and Conditional Logistic Regression |
| title_full_unstemmed | Determinants of Severe Late Ovarian Hyperstimulation Syndrome in Fresh Embryo Transfer Cycles Based on Integration of Decision Tree Classification and Conditional Logistic Regression |
| title_short | Determinants of Severe Late Ovarian Hyperstimulation Syndrome in Fresh Embryo Transfer Cycles Based on Integration of Decision Tree Classification and Conditional Logistic Regression |
| title_sort | determinants of severe late ovarian hyperstimulation syndrome in fresh embryo transfer cycles based on integration of decision tree classification and conditional logistic regression |
| topic | ovarian hyperstimulation syndrome fresh embryo transfer estradiol anti-mullerian hormone decision tree model |
| url | https://www.imrpress.com/journal/CEOG/50/2/10.31083/j.ceog5002036 |
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