February 19th, 2020

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Ovarian Sensitivity Index in the First in Vitro Fertilization Cycle Is as Good as the Bologna Criteria for Predicting Poor Ovarian Response in a Subsequent Treatment Cycle
Authors:  Jennifer Ka Yee Ko, M.B.B.S., MRCOG, Vivian Chi Yan Lee, M.D., FRCOG, Raymond Hang Wun Li, M.B.B.S., FRCOG, Pak Chung Ho, M.D., FRCOG, and Ernest Hung Yu Ng, M.D., FRCOG
  OBJECTIVE: To compare the Bologna criteria and ovarian sensitivity index (OSI) in the first in vitro fertilization (IVF) cycle for predicting poor ovarian response (POR) in a subsequent treatment cycle.

STUDY DESIGN: A retrospective study was performed involving women who underwent first cycle IVF treatment between January 2007 and December 2009 in our unit and had information on a second IVF cycle available. Women who were treated on the long GnRH agonist protocol in both the first and second treatment cycles were analyzed.

RESULTS: A total of 275 women were included. The Bologna criteria had a sensitivity of 21.2% (95% CI 9.0–38.9) and specificity of 95.4% (95% CI 92.0–97.7) in predicting POR in the second treatment cycle. At a cutoff of 2.4 per 1,000 IU (best Youden index), OSI had a significantly higher sensitivity (82.4%, 95% CI 65.5–93.2) but lower specificity (69.3%, 95% CI 63.1–75.1) when compared with the Bologna criteria in predicting POR. When OSI is adjusted to a cutoff of 1.1 per 1,000 IU for a specificity of 95.9% (95% CI 92.5–98.0), which is similar to that of the Bologna criteria, the sensitivity (20.6%, 95% CI 8.7–37.9) is the same as that of the Bologna criteria in predicting POR.

CONCLUSION: Using a cutoff of 1.1 per 1,000 IU, OSI is as good as the Bologna criteria in predicting POR in the second treatment cycle.
Keywords:  assisted reproductive technologies, Bologna criteria, female, follicle stimulating hormone/administration & dosage, follicle stimulating hormone/therapeutic use, gonadotropins/administration & dosage, gonadotropins/therapeutic use, humans, in vitro fertilization, oocyte retrieval, ovarian sensitivity index, ovary/drug effects, ovulation induction, poor ovarian response, reproductive medicine
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