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

Abstract

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.