Avtor/Urednik		Rakić, Ksenija; Vlaisavljević, Veljko; Reljič, Milan
Naslov		Ali lahko napovemo izostanek oploditve jajčnih celic v postopkih zunajtelesne oploditve?
Prevedeni naslov		Can total fertilization failure be predicted in in vitro fertilization cycles?
Tip		članek
Vir		Zdrav Vestn
Vol. in št.		Letnik 80, št. Suppl 1
Leto izdaje		2011
Obseg		str. I-64-71
Jezik		slo
Abstrakt		Objective: To analyze predictors of the IVF cycles with high risk of total fertilization failure (TFF). Methods: A retrospective analysis of 981 consecutive stimulated IVF cycles with successful oocyte retrieval. IVF cycles were divided into two groups. Group 1 consisted of IVF cycles with fertilization and group 2 of IVF cycles in which none of the oocytes were fertilized (TFF). The groups were compared according to female age, indications for IVF, stimulation protocol, number of oocytes and semen quality. Nonparametric statistics was used. Logistic regression and receiver operating characteristic (ROC) curve were used to determine which variables could be used to predict TFF. Result(s): TFF appeared in 84 (8.6 %) cycles. There were statistically significant differences in female age, number of oocytes, total and motile sperm concentration between the groups. Univariate logistic regression analysis showed significant prediction of TFF by duration of stimulation, number of ampoules used, number of oocytes and motile sperm concentration. According to multivariate analysis, the only two variables that can predict TFF are the number of oocytes (OR 1.25, p = 0.000) and motile sperm concentration (OR 1.01, p = 0.03). With ROC analysis we have determined that the number of oocytes and motile sperm concentration have good predictive value for TFF. The most appropriate cut-off value for number of oocytes was 3, with 81.1 % sensitivity and 60.0 % specificity. We did not manage to define appropriate cut-off value, which could predict TFF for motile sperm concentration. The area under the curve (AUC) for number of oocytes was 0.754, p = 0.000 and for motile sperm concentration 0.631, p = 0.000. Conclusion(s): According to our results, TFF in IVF cycles can be predicted only by low number of oocytes (poor responders) and lower motile sperm concentration.
Izvleček		Izhodišča: Z raziskavo smo želeli ugotoviti dejavnike, s katerimi bi lahko napovedali postopke zunajtelesne oploditve (IVF) s povečanim tveganjem za popolni izostanek oploditve jajčnih celic (TFF). Metode: Retrospektivno smo analizirali 981 hormonsko spodbujenih ciklov IVF, pri katerih smo pri aspiraciji jajčnih foliklov dobili vsaj eno jajčno celico. Postopke IVF smo razdelili v dve skupini, in sicer glede na to, ali je prišlo do oploditve jajčne celice (Skupina 1) ali pa oploditve jajčnih celic ni bilo (Skupina 2). Med skupinama smo primerjali starost bolnic, indikacije za vključitev v postopek IVF, protokole stimulacije, število jajčnih celic in kakovost semena ter ugotavljali najprimernejše napovedne dejavnike za popolni izostanek oploditve jajčnih celic (angl. total fertilization failure,TFF). Za analizo smo uporabili neparametrično statistiko, univariatno in multivariatno logistično regresijo ter krivuljo občutljivosti in specifičnosti (krivuljo ROC). Rezultati: V 84 (8,6 %) postopkih smo ugotovili TFF. Skupina z uspešno oploditvijo jajčnih celic in skupina z TFF sta se statistično pomembno razlikovali glede starosti bolnic, števila jajčnih celic, glede koncentracije semenčic in koncentracije gibljivih semenčic. Z metodo univariatne logistične regresije smo ugotovili, da so spremenljivke trajanje spodbujanja ovulacije, število uporabljenih ampul folitropina, število jajčnih celic ter koncentracija gibljivih semenčic statistično pomembno povezane s TFF. Multivariatna logistična regresija je pokazala, da sta edina pomembna napovedna dejavnika za TFF število jajčnih celic (razmerje obetov 1,25; p = 0,000) in koncentracija gibljivih semenčic (razmerje obetov 1,01; p = 0,03). S številom jajčnih celic 3 ali manj lahko z 81,1-odstotno občutljivostjo in 60,0 % specifičnostjo napovemo cikle s povečanim tveganjem za TFF. Najprimernejše mejne vrednosti koncentracije gibljivih semenčic za napoved TFF nismo uspeli določiti. (Izvl. skrajšan na 2000 zn.)
Deskriptorji		FERTILIZATION IN VITRO OOCYTES SPERM MOTILITY