Younis et al developed a simple score for predicting low ovarian reserve of oocytes in an infertile woman. This will impact the woman's pregnancy rate and the success of in vitro ferilization. The authors are from Poriya Medical Center in Tiberias, Israel.
Patient selection: female 19 to 44 years of age with 2 intact ovaries and no evidence of thyroid disease, diabetes mellitus, significant hyperprolactinemia or hypogonadotropic hypogonadism. The number of cancellations for low ovarian response is limited to 1 or 2.
Outcome: low ovarian reserve (<= 3 oocytes retrieved)
Parameters:
(1) body weight in kilograms
(2) body height in meters
(3) number of previous IVF cancellations (due to low ovarian response)
(4) duration of infertility in years
(5) mean ovarian volume in cubic centimeters
(6) basal FSH in mIU/mL
(7) basal FSH to LH ratio
(8) antral follicle count (2 to 10 mm in diameter, both ovaries, by ultrasound)
(9) age in years
body mass index =
= (body weight in kilograms) / ((body height in meters)^2)
FSH to LH ratio =
= (FSH) / (LH)
|
Parameter |
Finding |
Points |
|
body mass index |
<= 30 kg per square meter |
1 |
|
|
> 30 kg per square meter |
2 |
|
number of previous cancellations |
1 |
1 |
|
|
2 |
2 |
|
infertility duration |
<= 2 years (*) |
1 |
|
|
2 to 10 years (*) |
2 |
|
|
> 10 years |
3 |
|
mean ovarian volume |
> 10 cubic centimeters |
1 |
|
|
5 to 10 cubic centimeters (*) |
2 |
|
|
<= 5 cubic centimeters (*) |
3 |
|
basal FSH to LH ratio |
<= 2 (*) |
1 |
|
|
2 to 4 (*) |
2 |
|
|
> 4 |
3 |
|
basal FSH |
<= 6 mIU/mL (*) |
1 |
|
|
6 to 8 (*) |
2 |
|
|
8 to 12 (*) |
3 |
|
|
12 to 15 |
4 |
|
|
> 15 |
5 |
|
antral follicle count |
> 12 |
1 |
|
|
10 to 12 |
2 |
|
|
7 to 9 |
3 |
|
|
4 to 6 |
4 |
|
|
<= 3 |
5 |
|
age in years |
<= 25 years |
1 |
|
|
26 to 30 years |
2 |
|
|
31 to 35 years |
3 |
|
|
36 to 40 years |
4 |
|
|
>= 41 years |
5 |
where:
• The (*) indicate where ranges overlap.
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 8
• maximum score: 28
• A score > 14 was associated with low ovarian reserve.
Performance:
• The area under the ROC curve was 0.90.
Specialty: Obstetrics & Gynecology
