Overweight and high serum total cholesterol were risk factors for the outcome of IVF/ICSI cycles in PCOS patients and a PCOS-specific predictive model of live birth rate was established
Overweight and high serum total cholesterol were risk factors for the outcome of IVF/ICSI cycles in PCOS patients and a PCOS-specific predictive model of live birth rate was established
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DOI：
10.1007/s40618-020-01209-5
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发表时间：
2020-03-27
影响因子：
5.4
通讯作者：
Yang, X.
中科院分区：
文献类型：
--
作者：
Gao, L.;Li, M.;Yang, X.
目的体外受精(IVF)和卵胞浆内单精子注射(ICSI)治疗多囊卵巢综合征(PCOS)不孕症的临床结局各不相同。这项研究的目的是开发一个基于患者特征关联的诺模图来预测多囊卵巢综合征患者的活产率。方法选择2014年1月至2018年10月在某公立大学医院接受IVF/ICSI治疗的PCOS不孕症患者。诺模图是从178名连续患者的训练队列中建立的，并在81名患者的独立验证队列上进行了测试。所有参与者都确认了多囊卵巢综合征。结果BMI、血清总胆固醇(TC)和基础FSH是影响PCOS患者出生率的3个变量。根据体重指数、总胆固醇、基础卵泡刺激素、移植胚胎类型和年龄建立的预测模型具有良好的校正和判别能力，训练队列的曲线下面积为0.708(95%CI 0.632-0.785)。诺模图在独立验证队列中显示出令人满意的拟合优度和辨别能力，AUC值为0.686(95%CI 0.556-0.815)。结论我们的简单循证标准图提供了PCOS患者IVF/ICSI结局的图形化危险因素和预后模型，可为临床医生和患者个体化辅助治疗提供有用的指导。
Purpose The clinical outcome after in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) is diverse in infertility patients with polycystic ovary syndrome (PCOS). The aim of this study was to develop a nomogram based on an association of patients' characteristics to predict the live birth rate in PCOS patients. Methods All women in a public university hospital who attempted to conceive by IVF/ICSI for PCOS infertility from January 2014 to October 2018 were included. The nomogram was built from a training cohort of 178 consecutive patients and tested on an independent validation cohort of 81 patients. PCOS was confirmed in all participants. Results Three variates significantly associated with live birth rate of PCOS patients were BMI, total serum cholesterol (TC) and basal FSH. This predictive model built on the basis of BMI, TC, basal FSH, type of embryo transferred and age showed good calibration and discriminatory abilities, with an area under the curve (AUC) of 0.708 (95% CI 0.632-0.785) for the training cohort. The nomogram showed satisfactory goodness-of-fit and discrimination abilities in the independent validation cohort, with an AUC of 0.686 (95% CI 0.556-0.815). Conclusion Our simple evidence-based nomogram presents graphically risk factors and prognostic models for IVF/ICSI outcomes in patients with PCOS, which can offer useful guidance to clinicians and patients for individual adjuvant therapy.