Prediction of Ovarian Response with Ovarian Response Prediction Index (ORPI) during Controlled Ovarian Stimulation in IVF

Abstract

(Background): To evaluate ORPI as an index to predict the response to ovarian stimulation. (Methods): It is an observational prospective study of 734 patients who underwent controlled ovarian stimulation during period of 1.5 years (July 2017 to December 2018). Inclusion and exclusion criteria were taken into consideration when patients were recruited. ORPI is calculated by multiplying AMH level (ng/ml) and AFC (n) and the result is divided by age (years) of the patient. The primary outcome measured was number of MII oocytes and secondary outcome was total number of oocytes retrieved. (Results): Positive correlation of ORPI with MII oocytes and total number of oocytes is seen. Regarding the probability of collecting ≥4 oocytes under the ROC curve, the AUC for ORPI is 0.68 (95%CI 0.65-0.72) with sensitivity of 78.4 and specificity of 51.4 for a cut off of >0.44. For collecting ≥ 15 oocytes ROC curve had an AUC of 0.72 with sensitivity of 66.7 and specificity of 73.4 for a cut off of >1.28. ROC curve for the probability of collecting ≥4 MII oocytes depicted an AUC of 0.67 with cut off of >0.77. (Conclusion): The results of our study concluded that in a patient undergoing IVF treatment, ORPI has a poor ability to predict retrieval of ≥4 oocytes or ≥ 4 MII and fair ability for hyper response with ≥15 oocytes. ORPI can serve as a counselling tool for predicting ovarian response.