预测接受卵巢刺激试管婴儿患者 LH 过早升高的临床参数。

IF 2 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM
Gynecological Endocrinology Pub Date : 2024-12-01 Epub Date: 2024-06-30 DOI:10.1080/09513590.2024.2365913
Maya Nasatzky, Yonathan Belicha, Ofer Fainaru
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引用次数: 0

摘要

背景:正常的生殖功能需要卵泡刺激素(FSH)和黄体生成素(LH)分泌的充分调节。在体外受精(IVF)的卵巢刺激过程中,尽管使用了促性腺激素释放激素(GnRH)拮抗剂,但一些患者仍会出现 LH 过早升高的现象,有时不得不取消周期。以往的研究表明,LH过早升高与卵巢对促性腺激素的反应可能存在联系。我们试图确定哪些临床参数可预测 LH 过早升高及其相对作用。研究方法对兰巴姆医疗中心接受试管婴儿治疗的 382 名患者进行回顾性研究。患者被分为不同的年龄组。采用多元线性回归和基于机器学习的算法,根据临床和人口学参数建立了预测 LH 过早升高的模型。结果显示LH升高被定义为触发前与基础LH水平之间的差值。能显著预测 LH 升高的临床参数包括患者年龄、体重指数、刺激开始时的 LH 水平、使用拮抗剂当天的 LH 水平以及刺激天数总数。重要的是,在分析特定年龄组的数据时,该模型对年轻患者的预测能力最强(25-30 岁,R2 = 0.88,41 岁,R2 = 0.23,p = .003)。结论通过对试管婴儿周期的患者数据进行多元线性回归和基于机器学习的算法,我们能够预测有LH过早升高和/或LH激增风险的患者。利用该模型有助于防止试管婴儿周期取消,并更好地把握排卵触发时机。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical parameters that predict a premature LH rise in patients undergoing ovarian stimulation for IVF.

Background: Normal reproductive function requires adequate regulation of follicle stimulating hormone (FSH) and luteinizing hormone (LH) secretion. During ovarian stimulation for in-vitro fertilization (IVF), some patients will demonstrate an early rise in LH despite being treated with a gonadotropin releasing-hormone (GnRH) antagonist, sometimes necessitating cycle cancellation. Previous studies have demonstrated a possible link between a premature LH rise with ovarian response to gonadotropins. We sought to determine what clinical parameters can predict this premature LH rise and their relative contribution. Methods: A retrospective study of 382 patients who underwent IVF treatment at Rambam Medical Center. The patients were stratified into age groups. A model predicting premature LH rise based on clinical and demographic parameters was developed using both multiple linear regression and a machine-learning-based algorithm. Results: LH rise was defined as the difference between pre-trigger and basal LH levels. The clinical parameters that significantly predicted an LH rise were patient age, BMI, LH levels at stimulation outset, LH levels on day of antagonist administration, and total number of stimulation days. Importantly, when analyzing the data of specific age groups, the model's prediction was strongest in young patients (age 25-30 years, R2 = 0.88, p < .001) and weakest in older patients (age > 41 years, R2 = 0.23, p = .003). Conclusions: Using both multiple linear regression and a machine-learning-based algorithm of patient data from IVF cycles, we were able to predict patients at risk for premature LH rise and/or LH surge. Utilizing this model may help prevent IVF cycle cancellation and better timing of ovulation triggering.

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来源期刊
Gynecological Endocrinology
Gynecological Endocrinology 医学-妇产科学
CiteScore
4.40
自引率
5.00%
发文量
137
审稿时长
3-6 weeks
期刊介绍: Gynecological Endocrinology , the official journal of the International Society of Gynecological Endocrinology, covers all the experimental, clinical and therapeutic aspects of this ever more important discipline. It includes, amongst others, papers relating to the control and function of the different endocrine glands in females, the effects of reproductive events on the endocrine system, and the consequences of endocrine disorders on reproduction
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