Abstract
Objective: The objective of this study is to assess if the difference of repeated measurements of estradiol and progesterone during luteal phase predict the outcome of intrauterine insemination.
Design: Prospective study.
Setting: Reproductive clinic.
Patients: 126 patients with infertility.
Intervention(s): Patients underwent controlled ovarian stimulation with recombinant FSH (50–150 IU/d). The day of IUI patients were given p.o natural micronized progesterone in a dose of 100 mg/tds.
Results: The area under the receiver characteristic operating curve (ROC curve) in predicting clinical pregnancy for % change of estradiol level on days 6 and 10 was 0.892 with 95% CI: 0.82–0.94. A cutoff value of change > −29.5% had a sensitivity of 85.7 with a specificity of 90.2. The corresponding ROC curve for % change of progesterone level was 0.839 with 95% CI: 0.76–0.90. A cutoff value of change > −33% had a sensitivity of 85 with a specificity of 75.
Conclusions: The % change of estradiol and progesterone between days 6 and 10 has a predictive ability of pregnancy after IUI with COS of 89.2% and 83.4%, respectively. The addition of % of progesterone to % change of estradiol does not improve the predictive ability of % estradiol and should not be used.
Chinese abstract
目的:本研究的目的是评估黄体期雌二醇和孕酮重复测量的差异是否预示宫腔内人工授精(IUI)的结果。
设计:前瞻性研究。
环境:生殖诊所。
患者:126例不育症患者。
干预措施:患者接受重组FSH(50-150IU/d)进行控制性卵巢刺激(COS)。 一天给予IUI患者口服天然微粉化孕酮剂量为100mg , 3次/日。
结果:通过雌二醇水平在第6天和10天的百分比变化预测临床妊娠的受试者特征曲线(ROC曲线)面积为0.892, 95%可信区间为0.82-0.94。变化> -29.5%的临界值灵敏性为85.7, 特异性为90.2。孕酮水平百分比变化的相应ROC曲线面积为0.839, 95%可信区间为0.76-0.90。变化大于-33%的临界值的灵敏性为85, 特异性为75。
结论:第6和10天雌二醇和孕激素的变化百分比对COS以后进行的IUI的妊娠的预测能力分别为89.2%和83.4%。在雌二醇的百分比变化中增加孕酮百分比, 不会改善雌二醇的预测能力, 不应使用。
Declaration of interest
The authors report no conflicts of interest.