Prestimulation parameters predicting live birth in anovulatory WHO Group II patients undergoing ovulation induction with gonadotrophins
Authors: Nyboe Andersen, A.; Balen, A.H.; Platteau, P.; Pettersson, G.; Arce, J.-C.
Source: Human Reproduction, Volume 25, Number 8, 11 August 2010 , pp. 1988-1995(8)
Publisher: Oxford University Press
Abstract:BACKGROUNDThe objective of this study was to identify baseline predictors of live birth in anovulatory patients undergoing ovulation induction, and based on these predictors, develop nomograms for estimation of the probability of live birth in a single cycle.METHODSUnivariate and multivariate logistic regression were used for retrospective analysis of clinical, sonographic and endocrinological parameters collected prior to the start of ovarian stimulation in a cohort of anovulatory World Health Organization (WHO) Group II patients (n 335), who were resistant to clomiphene citrate (CC) and therefore stimulated with gonadotrophins using a low-dose step-up protocol.RESULTSThe univariate analysis identified age [OR 0.91 (95 CI: 0.840.98), P 0.015], duration of infertility [OR 0.71 (95 CI: 0.560.91), P 0.007], serum follicle stimulating hormone (FSH) concentration at the start of stimulation [OR 0.83 (95 CI: 0.690.99), P 0.034] and menstrual cycle pattern (P 0.022) as significant predictors of live birth. Baseline concentrations of luteinizing hormone, androgens, glucose and insulin, as well as body mass index, were not predictors of live birth. In the multivariate analysis, duration of infertility, FSH and menstrual cycle pattern were independent predictors, and nomograms were designed with these three parameters for individual prediction of the probability of live birth.CONCLUSIONSThe chances of live birth in women with WHO Group II anovulatory infertility resistant to CC undergoing ovulation induction with gonadotrophins is highly influenced by the menstrual cycle pattern. Increases in duration of infertility and concentration of FSH (within the normal range) before the start of stimulation have negative influences on the likelihood of achieving a live birth.
Document Type: Research article
Publication date: 2010-08-11
- Human Reproduction features full-length, peer-reviewed papers reporting original research, clinical case histories, as well as opinions and debates on topical issues. Papers published cover the scientific and medical aspects of reproductive physiology and pathology, endocrinology, andrology, gonad function, gametogenesis, fertilization, embryo development, implantation, pregnancy, genetics, genetic diagnosis, oncology, infectious disease, surgery, contraception, infertility treatment, psychology, ethics and social issues. The highest scientific and editorial standard is maintained throughout the journal along with a rapid rate of publication.