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Predictive factors for oocyte retrieval failure in controlled ovarian hyperstimulation protocols: a retrospective observational cohort study

BACKGROUND: Oocyte retrieval failure following an ovarian hyperstimulation protocol is uncommon in assisted reproductive technology (ART) programs. We analyzed the predictive factors for oocyte retrieval failure following controlled ovarian hyperstimulation (COH) with gonadotropin-releasing hormone...

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Autores principales: Hasegawa, Ayumi, Takahashi, Toshifumi, Igarashi, Hideki, Amita, Mitsuyoshi, Matsukawa, Jun, Nagase, Satoru
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4455053/
https://www.ncbi.nlm.nih.gov/pubmed/26033112
http://dx.doi.org/10.1186/s12958-015-0052-x
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author Hasegawa, Ayumi
Takahashi, Toshifumi
Igarashi, Hideki
Amita, Mitsuyoshi
Matsukawa, Jun
Nagase, Satoru
author_facet Hasegawa, Ayumi
Takahashi, Toshifumi
Igarashi, Hideki
Amita, Mitsuyoshi
Matsukawa, Jun
Nagase, Satoru
author_sort Hasegawa, Ayumi
collection PubMed
description BACKGROUND: Oocyte retrieval failure following an ovarian hyperstimulation protocol is uncommon in assisted reproductive technology (ART) programs. We analyzed the predictive factors for oocyte retrieval failure following controlled ovarian hyperstimulation (COH) with gonadotropin-releasing hormone (GnRH) agonist and GnRH antagonist protocols in ART programs. METHODS: This study was a retrospective cohort observational study. In total, 744 cycles from 361 patients who underwent controlled ovarian hyperstimulation with GnRH agonist long protocol or antagonist protocol were analyzed. Treatment cycles with oocyte retrieval failure and with one or more oocytes retrieved were compared to determine predictive factors for oocyte retrieval failure using univariate and multilevel multivariate logistic regression analyses. RESULTS: Oocyte retrieval failure occurred in 38 cycles (5.1 %). The oocyte retrieval failure rate of the GnRH antagonist protocol (8.1 %) was significantly higher than that of the GnRH agonist long protocol (3.7 %). On multilevel multivariate logistic analysis, cycles with GnRH antagonist protocol (odds ratio [OR] 3.06, 95 % confidence interval [CI] 1.05–8.96), estradiol level on the day of human chorionic gonadotropin (hCG) injection (OR 0.997, 95 % CI 0.996–0.998), and luteinizing hormone (LH) level on the day of hCG injection (OR 1.19, 95 % CI 1.06–1.33) were independent predictive factors for oocyte retrieval failure. The efficacy of estradiol and LH levels on the day of hCG injection for predicting oocyte retrieval failure was evaluated using receiver operating characteristic curves. In all cycles, the areas under the curve (AUCs) for estradiol and LH were 0.84 and 0.63, respectively, for all cycles; 0.84 and 0.52, respectively, for cycles with GnRH agonist long protocol; and 0.81 and 0.82, respectively, for cycles with GnRH antagonist protocol. CONCLUSIONS: Our results suggest that in cycles with GnRH antagonist protocol, the levels of estradiol and LH on the day of hCG injection might be predictive factors for oocyte retrieval failure. This relationship may provide useful information to both patients and physicians for developing better COH protocols in ART programs.
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spelling pubmed-44550532015-06-05 Predictive factors for oocyte retrieval failure in controlled ovarian hyperstimulation protocols: a retrospective observational cohort study Hasegawa, Ayumi Takahashi, Toshifumi Igarashi, Hideki Amita, Mitsuyoshi Matsukawa, Jun Nagase, Satoru Reprod Biol Endocrinol Research BACKGROUND: Oocyte retrieval failure following an ovarian hyperstimulation protocol is uncommon in assisted reproductive technology (ART) programs. We analyzed the predictive factors for oocyte retrieval failure following controlled ovarian hyperstimulation (COH) with gonadotropin-releasing hormone (GnRH) agonist and GnRH antagonist protocols in ART programs. METHODS: This study was a retrospective cohort observational study. In total, 744 cycles from 361 patients who underwent controlled ovarian hyperstimulation with GnRH agonist long protocol or antagonist protocol were analyzed. Treatment cycles with oocyte retrieval failure and with one or more oocytes retrieved were compared to determine predictive factors for oocyte retrieval failure using univariate and multilevel multivariate logistic regression analyses. RESULTS: Oocyte retrieval failure occurred in 38 cycles (5.1 %). The oocyte retrieval failure rate of the GnRH antagonist protocol (8.1 %) was significantly higher than that of the GnRH agonist long protocol (3.7 %). On multilevel multivariate logistic analysis, cycles with GnRH antagonist protocol (odds ratio [OR] 3.06, 95 % confidence interval [CI] 1.05–8.96), estradiol level on the day of human chorionic gonadotropin (hCG) injection (OR 0.997, 95 % CI 0.996–0.998), and luteinizing hormone (LH) level on the day of hCG injection (OR 1.19, 95 % CI 1.06–1.33) were independent predictive factors for oocyte retrieval failure. The efficacy of estradiol and LH levels on the day of hCG injection for predicting oocyte retrieval failure was evaluated using receiver operating characteristic curves. In all cycles, the areas under the curve (AUCs) for estradiol and LH were 0.84 and 0.63, respectively, for all cycles; 0.84 and 0.52, respectively, for cycles with GnRH agonist long protocol; and 0.81 and 0.82, respectively, for cycles with GnRH antagonist protocol. CONCLUSIONS: Our results suggest that in cycles with GnRH antagonist protocol, the levels of estradiol and LH on the day of hCG injection might be predictive factors for oocyte retrieval failure. This relationship may provide useful information to both patients and physicians for developing better COH protocols in ART programs. BioMed Central 2015-06-02 /pmc/articles/PMC4455053/ /pubmed/26033112 http://dx.doi.org/10.1186/s12958-015-0052-x Text en © Hasegawa et al. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Hasegawa, Ayumi
Takahashi, Toshifumi
Igarashi, Hideki
Amita, Mitsuyoshi
Matsukawa, Jun
Nagase, Satoru
Predictive factors for oocyte retrieval failure in controlled ovarian hyperstimulation protocols: a retrospective observational cohort study
title Predictive factors for oocyte retrieval failure in controlled ovarian hyperstimulation protocols: a retrospective observational cohort study
title_full Predictive factors for oocyte retrieval failure in controlled ovarian hyperstimulation protocols: a retrospective observational cohort study
title_fullStr Predictive factors for oocyte retrieval failure in controlled ovarian hyperstimulation protocols: a retrospective observational cohort study
title_full_unstemmed Predictive factors for oocyte retrieval failure in controlled ovarian hyperstimulation protocols: a retrospective observational cohort study
title_short Predictive factors for oocyte retrieval failure in controlled ovarian hyperstimulation protocols: a retrospective observational cohort study
title_sort predictive factors for oocyte retrieval failure in controlled ovarian hyperstimulation protocols: a retrospective observational cohort study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4455053/
https://www.ncbi.nlm.nih.gov/pubmed/26033112
http://dx.doi.org/10.1186/s12958-015-0052-x
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