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Ovarian reserve markers in unexplained infertility patients treated with clomiphene citrate during intrauterine insemination.

Oner G, Ulug P, Elmali F - Arch Med Sci (2015)

Bottom Line: Increasing FSH was associated with a reduction in AFC (r = -0.273, p = 0.025).The AFC was significantly correlated with ovarian volume (r = 0.660, p < 0.0001) and FSH (r = -0.273, p = 0.03).Our data demonstrate that the AFC provides better prognostic information on the occurrence of ovarian response during clomiphene citrate stimulation for IUI.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Erzincan University, Erzincan, Turkey.

ABSTRACT

Introduction: The aim of this retrospective case control study was to identify predictors of ovarian response and pregnancy outcomes in intrauterine insemination (IUI).

Material and methods: One hundred women undergoing IUI cycles with clomiphene citrate were enrolled. The number of antral follicles and the total ovarian volume by ultrasound, and the basal levels of follicle-stimulating hormone (FSH), estradiol, and inhibin B on cycle day 3 were measured in groups that were divided according to ovarian response. The tests were also evaluated according to ovarian response and pregnancy outcomes. All analyses were performed using the Statistical Package for the Social Sciences, version 15.0 (SPSS, Chicago, IL, USA).

Results: The antral follicle count (AFC) was the best single predictor for ovarian response and pregnancy outcomes. The sensitivity and specificity for prediction of ovarian response were 81% and 78% for AFC at an optimum cutoff value of ≤ 13.1. Age was negatively correlated with ovarian volume (r = -0.280, p = 0.021) and AFC (r = -0.358, p = 0.003). Increasing FSH was associated with a reduction in AFC (r = -0.273, p = 0.025). The AFC was significantly correlated with ovarian volume (r = 0.660, p < 0.0001) and FSH (r = -0.273, p = 0.03).

Conclusions: Our data demonstrate that the AFC provides better prognostic information on the occurrence of ovarian response during clomiphene citrate stimulation for IUI.

No MeSH data available.


ROC curve analysis of antral follicle count
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Figure 0001: ROC curve analysis of antral follicle count

Mentions: Table I summarizes patients’ demographics, basal FSH, AMH, and AFC in the two study groups. There was no difference between the ages of the groups. Body mass index (BMI) was similar in both groups. Group 2 had a lower total AFC (p < 0.001) and smaller ovaries (p < 0.05), but there was no statistically significant difference between the serum FSH levels of groups. The other endocrine (basal LH, E2, and inhibin-B) markers were similar in both groups. Multivariate logistic regression analysis of the variables was performed for the prediction of oocytes ≥ 16 mm in diameter. The AFC was the only significant predictor on multivariate analysis (1.121, 95% CI: 1.014–1.372; p = 0.035). In group 1, similar results were obtained for prediction of pregnancy, with several of the measures being predictive on univariate logistic regression analyses, which again revealed AFC as a significant predictor (Table II). Additionally, ovarian volume was the other significant predictor of pregnancy (Table II). The ROC curve analysis (Figure 1) showed that AFC predicted the ovarian response, as demonstrated by a similar area under the curve (AUC) (p < 0.001). The optimum cutoff level of AFC was 13.1 with 81.4% sensitivity (95% CI: 69.1–90.3), 77.8% specificity (95% CI: 40.1–96.5), 3.66 positive likelihood ratio, and 0.24 negative likelihood ratio.


Ovarian reserve markers in unexplained infertility patients treated with clomiphene citrate during intrauterine insemination.

Oner G, Ulug P, Elmali F - Arch Med Sci (2015)

ROC curve analysis of antral follicle count
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4697041&req=5

Figure 0001: ROC curve analysis of antral follicle count
Mentions: Table I summarizes patients’ demographics, basal FSH, AMH, and AFC in the two study groups. There was no difference between the ages of the groups. Body mass index (BMI) was similar in both groups. Group 2 had a lower total AFC (p < 0.001) and smaller ovaries (p < 0.05), but there was no statistically significant difference between the serum FSH levels of groups. The other endocrine (basal LH, E2, and inhibin-B) markers were similar in both groups. Multivariate logistic regression analysis of the variables was performed for the prediction of oocytes ≥ 16 mm in diameter. The AFC was the only significant predictor on multivariate analysis (1.121, 95% CI: 1.014–1.372; p = 0.035). In group 1, similar results were obtained for prediction of pregnancy, with several of the measures being predictive on univariate logistic regression analyses, which again revealed AFC as a significant predictor (Table II). Additionally, ovarian volume was the other significant predictor of pregnancy (Table II). The ROC curve analysis (Figure 1) showed that AFC predicted the ovarian response, as demonstrated by a similar area under the curve (AUC) (p < 0.001). The optimum cutoff level of AFC was 13.1 with 81.4% sensitivity (95% CI: 69.1–90.3), 77.8% specificity (95% CI: 40.1–96.5), 3.66 positive likelihood ratio, and 0.24 negative likelihood ratio.

Bottom Line: Increasing FSH was associated with a reduction in AFC (r = -0.273, p = 0.025).The AFC was significantly correlated with ovarian volume (r = 0.660, p < 0.0001) and FSH (r = -0.273, p = 0.03).Our data demonstrate that the AFC provides better prognostic information on the occurrence of ovarian response during clomiphene citrate stimulation for IUI.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Erzincan University, Erzincan, Turkey.

ABSTRACT

Introduction: The aim of this retrospective case control study was to identify predictors of ovarian response and pregnancy outcomes in intrauterine insemination (IUI).

Material and methods: One hundred women undergoing IUI cycles with clomiphene citrate were enrolled. The number of antral follicles and the total ovarian volume by ultrasound, and the basal levels of follicle-stimulating hormone (FSH), estradiol, and inhibin B on cycle day 3 were measured in groups that were divided according to ovarian response. The tests were also evaluated according to ovarian response and pregnancy outcomes. All analyses were performed using the Statistical Package for the Social Sciences, version 15.0 (SPSS, Chicago, IL, USA).

Results: The antral follicle count (AFC) was the best single predictor for ovarian response and pregnancy outcomes. The sensitivity and specificity for prediction of ovarian response were 81% and 78% for AFC at an optimum cutoff value of ≤ 13.1. Age was negatively correlated with ovarian volume (r = -0.280, p = 0.021) and AFC (r = -0.358, p = 0.003). Increasing FSH was associated with a reduction in AFC (r = -0.273, p = 0.025). The AFC was significantly correlated with ovarian volume (r = 0.660, p < 0.0001) and FSH (r = -0.273, p = 0.03).

Conclusions: Our data demonstrate that the AFC provides better prognostic information on the occurrence of ovarian response during clomiphene citrate stimulation for IUI.

No MeSH data available.