Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Broer, SL; Dólleman, M; van Disseldorp, J; Broeze, KA; Opmeer, BC; Bossuyt, PM; Eijkemans, MJ; Mol, BW; Broekmans, FJ; IPD-EXPORT Study Group.
Prediction of an excessive response in in vitro fertilization from patient characteristics and ovarian reserve tests and comparison in subgroups: an individual patient data meta-analysis.
Fertil Steril. 2013; 100(2):420-429
Doi: 10.1016/j.fertnstert.2013.04.024
Web of Science
PubMed
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- Study Group Mitglieder der Med Uni Graz:
- Ebner Thomas
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- Abstract:
- Objective: To evaluate whether ovarian reserve tests (ORTs) add prognostic value to patient characteristics, such as female age, in the prediction of excessive response to ovarian hyperstimulation in patients undergoing IVF, and whether their performance differs across clinical subgroups. Design: Authors of studies reporting on basal FSH, antimullerian hormone (AMH), or antral follicle count (AFC) in relation to ovarian response to ovarian hyperstimulation were invited to share original data. Random intercept logistic regression models were used to estimate added value of ORTs on patient characteristics, while accounting for between-study heterogeneity. Receiver operating characteristic regression analyses were performed to study the effect of patient characteristics on ORT accuracy. Setting: In vitro fertilization clinics. Patient(s): A total of 4,786 women for the main analysis, with a subgroup of 1,023 women with information on all three ORTs. Intervention(s): None. Main Outcome Measure(s): Excessive response prediction. Result(s): We included 57 studies reporting on 32 databases. Female age had an area under the receiver operating characteristic curve of 0.61 for excessive response prediction. Antral follicle count and AMH significantly added prognostic value to this. A model with female age, AFC, and AMH had an area under the receiver operating characteristic curve of 0.85. The combination of AMH and AFC, without age, had similar accuracy. Subgroup analysis indicated that FSH performed significantly worse in predicting excessive response in higher age groups, AFC did significantly better, and AMH performed the same. Conclusion(s): We demonstrate that AFC and AMH add value to female age in the prediction of excessive response and that, for AFC and FSH, the discriminatory performance is affected by female age. ((c) 2013 by American Society for Reproductive Medicine.)
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Cell Count - statistics & numerical data
- Female -
- Fertilization in Vitro - adverse effects
- Humans -
- Individuality -
- Infertility - diagnosis
- Maternal Age -
- Oocyte Retrieval - statistics & numerical data
- Ovarian Hyperstimulation Syndrome - diagnosis
- Ovary - cytology
- Ovulation Induction - adverse effects
- Pregnancy -
- Prognosis -
- Risk Factors -
- Find related publications in this database (Keywords)
- Assisted Reproduction
- antral folicle count
- antimullerian horme
- excessive response
- ovarian hyperstimulation syndrome