en بررسی عوامل مرتبط با ذخیره تخمدان در یک گروه با پاسخ ضعیف به لقاح آزمایشگاهی: یک مطالعه موضعی مقطعی Fertility & Infertility Original Article Original Article <strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">مقدمه: </span></span></strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">ذخیره پایین تخمدان و میزان بالای عدم موفقیت حاملگی با تخمک&shy;های با تعداد کم و کیفیت نامناسب در افرادی که پاسخ ضعیف به لقاح آزمایشگاهی دارند مشاهده شده است.</span></span><strong><span dir="LTR"><span style="font-family:Arial,sans-serif;"><span style="font-size:11.0pt;"></span></span></span></strong><br> <strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">هدف: </span></span></strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">بررسی اثر سن، میزان توده بدنی، آندومتریوز و سابقه جراحی تخمدان بر روی ذخیره تخمدان در یک گروه با پاسخ ضعیف به لقاح آزمایشگاهی.</span></span><br> <strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">مواد و روش &shy;ها: </span></span></strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">در این مطالعه موضعی مقطعی 749 زن که به کلینیک یاسمین بیمارستان عمومی ملی دکتر سیپتومانگونکوسومو ارجاع شده بودند از ژانویه 2013 تا ژوئن 2017 مورد مطالعه قرار گرفتند. دو تعریف پاسخ ضعیف و کریتریای پوسیدون استفاده شد و نمونه&shy;گیری به روش متوالی انجام شد. شرکت&shy;کنندگان بر اساس آزمایش ذخیره تخمدان به دو گروه با پاسخ ضعیف و خوب تقسیم شدند. شرکت&shy;کنندگانی که کمتر یا مساوی 3 تخمک داشتند در گروه با پاسخ ضعیف قرار گرفتند. بر این اساس 188 شرکت&shy;کننده با 9 تخمک (4 تا 47) در گروه با پاسخ ضعیف قرار گرفتند در حالیکه گروه با پاسخ خوب 2 تخمک (0 تا 3) داشتند.</span></span><span dir="LTR"><span style="font-family:Arial,sans-serif;"><span style="font-size:11.0pt;"></span></span></span><br> <strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">نتایج: </span></span></strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">سن و هورمون آنتی&shy;مولرین به طور معنی&shy;داری در ارتباط با ذخیره تخمدان در گروه با پاسخ ضعیف بود. در آنالیز چند متغیره سن تنها پیشگویی&shy;کننده پاسخ تخمدان در گروه با پاسخ ضعیف بود. آندومتریوز پیش&shy;گویی&shy;کننده معنی&shy;دار در گروه&shy;های پوسیدون 1 و 4 بود در حالیکه سابقه جراحی پیشگویی&shy;کننده معنی&shy;دار در گروه&shy;های پوسیدون 2 و 3 بود. نهایتا افزایش توده متوسط بدنی باعث کاهش ریسک طبق&shy;بندی شدن در گروه 3 پوسیدون شد.</span></span><strong><span dir="LTR"><span style="font-family:Arial,sans-serif;"><span style="font-size:11.0pt;"></span></span></span></strong><br> <strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">نتیجه&shy; گیری: </span></span></strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">سن، هورمون آنتی&shy;مولرین، متوسط توده بدنی، آندومتریوز و سابقه جراحی تخمدان می&shy;توانند ریسک طبقه&shy;بندی شدن در گروه&shy;های پوسیدون را تحت تأثیر قرار دهد.</span></span><strong><span dir="LTR"><span style="font-family:Arial,sans-serif;"><span style="font-size:11.0pt;"></span></span></span></strong> <div style="text-align: justify;"><strong>Background: </strong>Poor ovarian reserve and a high rate of pregnancy failure associated with low quality and quantity of oocytes are observed in poor responders to in vitro fertilization.<br> <strong>Objective: </strong>To assess the effect of age, body mass index (BMI), endometriosis, and history of ovarian surgery on ovarian reserve in a group of poor responders.<br> <strong>Materials and Methods:</strong> In this cross-sectional study 749 women who referred to Yasmin Clinic of Dr. Cipto Mangunkusumo National General Hospital from January 2013 to June 2017 were enrolled. Two definitions of poor responders and Poseidon criteria and consecutive sampling techniques were used. Participants were divided into good and poor responder groups based on the ovarian reserve test; participant with oocyte &le; 3 was classified as a poor responder. Based on this, 188 participants with nine (4-47) oocytes were included in the poor responder group. While, good responder comprised of two (0-3) oocytes.<br> <strong>Results: </strong>Age and anti-Mullerian hormone level (AMH) were significantly associated with ovarian reserve in the poor-responder group (p < 0.001). However, in multivariate analyses, age was the only significant predictor of ovarian response in the poor-responder group (p = 0.004). While endometriosis was the significant predictor of Poseidon groups 1 and 4, surgical history was the significant predictor of Poseidon groups 2 and 3. Meanwhile, an increase in BMI decreased the risk of classification under Poseidon group 3.<br> <strong>Conclusion: </strong>Age, AMH, BMI, endometriosis, and history of ovarian surgery affected the risk of classification of the Poseidon group.</div> ذخیره تخمدان, پوسیدون, لقاح آزمایشگاهی. Ovarian reserve, Poseidon, In vitro fertilization. 1065 1072 http://ijrm.ir/browse.php?a_code=A-10-925-5&slc_lang=en&sid=1 Budi Wiweko wiwekobudi@yahoo.co.id 0000-0002-5898-7034 Yes Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. Yasmin IVF Clinic, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia. Human Reproductive, Infertility and Family Planning Research Center, Indonesia Medical Education and Research Institute (IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. Quamila Fahrizani Afdi quamilaafdi@gmail.com 0000-0002-2094-1700 No Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. Achmad Kemal Harzif kemal.achmad@gmail.com 0000-0002-3552-1610 No Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. Yasmin IVF Clinic, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia. Human Reproductive, Infertility and Family Planning Research Center, Indonesia Medical Education and Research Institute (IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. Gita Pratama gitapratama@yahoo.com 0000-0002-2069-5327 No Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. Yasmin IVF Clinic, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia. Human Reproductive, Infertility and Family Planning Research Center, Indonesia Medical Education and Research Institute (IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. Kanadi Sumapraja kanadisuma@yahoo.com 0000-0003-3360-8779 No Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. Yasmin IVF Clinic, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia. Human Reproductive, Infertility and Family Planning Research Center, Indonesia Medical Education and Research Institute (IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. Raden Muharam r.muharam@yahoo.com 0000-0001-5712-3931 No Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. Yasmin IVF Clinic, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia. Human Reproductive, Infertility and Family Planning Research Center, Indonesia Medical Education and Research Institute (IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. Andon Hestiantoro hestiantoro@gmail.com 0000-0001-7424-679X No Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. Yasmin IVF Clinic, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia. Human Reproductive, Infertility and Family Planning Research Center, Indonesia Medical Education and Research Institute (IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. Sarah Chairani Zakirah sarahchairani@gmail.com 0000-0002-2918-8970 No Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.