Trigger day serum progesterone/oocyte number ratio as a predictor of pregnancy outcomes in patients with diminished ovarian reserve undergoing IVF-ET
Objective To investigate the predictive value of the ratio of serum progesterone on the trigger day to the number of oocytes retrieved index(POI)for the pregnancy outcomes of patients with diminished ovarian reserve(DOR)undergoing in vitro fertilization-embryo transfer(IVF-ET),aiming to provide support for clinical decision-making.Methods A total of 135 DOR patients who underwent IVF-ET treatment at Yancheng Maternal and child Health Care Hospital Afficiated to Yangzhou University from January 2021 to December 2023 were selected as the study participants.Patients were assigned to a pregnancy group(n=74)and a non-pregnancy group(n=61)based on their IVF-ET pregnancy outcomes.Clinical data of the two groups were collected and POI values of all patients were compared.The predictive value of serum progesterone on the trigger day,the number of oocytes retrieved,and POI for the pregnancy outcomes of DOR patients undergoing IVF-ET were assessed using the receiver operating characteristic(ROC)curve.A multivariate logistic regression analysis was used to explore the influencing factors of IVF-ET pregnancy outcomes.Results Serum progesterone on the trigger day and POI in the non-pregnancy group were higher than those in the pregnancy group,while the number of oocytes retrieved was lower in the non-pregnancy group,with statistical significance(P＜0.05).The areas under the curve(AUC)for predicting the pregnancy outcomes of DOR patients undergoing IVF-ET for serum progesterone on the trigger day,the number of oocytes retrieved,and POI were 0.792(0.742-0.837),0.833(0.788-0.878),and 0.921(0.876-0.966),respectively.When comparing the two groups,the pregnancy group had higher levels of anti-Müllerian hormone(AMH)and estradiol(E2),and a higher proportion of patients with ≥5 follicles and ≥3 good-quality embryos,with statistically significant differences(P＜0.05).Multivariate logistic regression analysis showed that reduced AMH(OR=2.465,95％CI:1.224-4.962),reduced E2(OR=2.335,95％CI:1.104-4.937),serum progesterone on the trigger day ≥0.87 ng/mL(OR=1.917,95％CI:1.136-3.236),number of oocytes retrieved ≤4.37(OR=2.787,95％CI:1.426-5.448),and POI ≥0.25(OR=3.943,95％CI:1.951-7.970)are risk factors for the pregnancy outcomes of DOR patients undergoing IVF-ET(P＜0.05).Conclusion The POI shows a high predictive value for the pregnancy outcomes of DOR patients undergoing IVF-ET,and its predictive ability is superior to that of serum progesterone on the trigger day or the number of oocytes re-trieved alone.A POI ≥0.25 serves as an important factor affecting the pregnancy outcomes of DOR patients undergoing IVF-ET.Additionally,AMH and E2 levels are also independent influencing factors of pregnancy outcomes.
In vitro fertilization-embryo transferDiminished ovarian reservePregnancy outcomesProgesteroneProges-terone to oocyte index
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维普
