en ارتباط بین سطح پروژسترون خون در روز تحریک و بازیابی کم تخمک در موارد مبتلا به سندرم تخمدان پلی‌کیستیک تحت لقاح مصنوعی: یک مطالعه کوهورت آینده‌نگر Assisted Reproductive Technologies Original Article Original Article <div style="text-align: justify;"><span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مقدمه: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">تعداد تخمک‌های بازیابی شده همیشه با تعداد فولیکول‌های آسپیره شده در درمان لقاح آزمایشگاهی/تزریق اسپرم داخل سیتوپلاسمی (</span></span><span dir="LTR" style="font-size:10.0pt">IVF/ICSI</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) مطابقت ندارد.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">هدف: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">هدف از انجام این مطالعه، بررسی توزیع داده&shy;های میزان بازیابی تخمک (</span></span><span dir="LTR" style="font-size:10.0pt">ORR</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) و بررسی عوامل خطر برای </span></span><span dir="LTR" style="font-size:10.0pt">ORR</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> پایین در بیماران مبتلا به سندرم تخمدان پلی&shy;کیستیک (</span></span><span dir="LTR" style="font-size:10.0pt">PCOS</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) تحت </span></span><span dir="LTR" style="font-size:10.0pt">IVF/ICSI</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">بود.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مواد و روش&shy; ها: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">این مطالعه کوهورت آینده&shy;نگر بر روی 140 زن باردار 40-18 ساله مبتلا به سندرم تخمدان پلی&shy;کیستیک که از اسفند 1402 تا آبان 1403 برای درمان </span></span><span dir="LTR" style="font-size:10.0pt">ICSI/IVF</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> به بیمارستان عمومی زنان آرش تهران مراجعه کرده بودند، انجام شد. نرخ بازیابی تخمک به عنوان نسبت تعداد تخمک&shy;های به دست آمده به تعداد فولیکول&shy;ها (</span></span><span lang="FA" style="font-size:10.0pt">&ge;</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">17 میلی&shy;متر) در روز تحریک تخمدان محاسبه شد. شرکت&shy;کنندگان به یک گروه </span></span><span dir="LTR" style="font-size:10.0pt">ORR</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> پایین و یک گروه </span></span><span dir="LTR" style="font-size:10.0pt">ORR</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> نرمال هر کدام با 70 زن با مرز یک انحراف معیار از مقدار میانگین </span></span><span dir="LTR" style="font-size:10.0pt">ORR</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> تقسیم شدند. </span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نتایج: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">از نظر سطح پروژسترون بین گروه‌های </span></span><span dir="LTR" style="font-size:10.0pt">ORR</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> پایین و نرمال تفاوت معنی‌داری مشاهده نشد. از نظر نسبت استرادیول به فولیکول بالای 17، تعداد فولیکول&shy;های بالای 17 و تعداد تخمک&shy;های بازیابی شده بین گروه&shy;های </span></span><span dir="LTR" style="font-size:10.0pt">ORR</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> کم و طبیعی تفاوت آماری معنی&shy;داری وجود داشت. تجزیه و تحلیل رگرسیون لجستیک نشان داد که نسبت استرادیول به فولیکول سرم (</span></span><span lang="FA" style="font-size:10.0pt">&ge;</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> 17 میلی‌متر) با (001/0 </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> {98/0-94/0} </span></span><span dir="LTR" style="font-size:10.0pt">CI</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> 95%، 96/0 = </span></span><span dir="LTR" style="font-size:10.0pt">OR</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) یک عامل مؤثر بر </span></span><span dir="LTR" style="font-size:10.0pt">ORR</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> پایین بود.</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial",sans-serif"></span></span></span></span></span></span></span><br> <b><span dir="RTL" lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نتیجه&shy; گیری: </span></span></b><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">ORR</span></span> <span dir="RTL" lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">پایین، که منجر به جنین‌های کمتر و لغو سیکل‌های بیشتر می‌شود، ممکن است ناشی از سطوح پایین پروژسترون در روز شروع، سطوح پایین استرادیول/فولیکول‌ها (</span></span><span dir="RTL" lang="FA" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">&ge;</span></span><span dir="RTL" lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> 17 میلی‌متر) و استفاده از رژیم اولیه پروژسترون در موارد </span></span><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">PCOS</span></span><span dir="RTL" lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> باشد.</span></span></div> <div style="text-align: justify;"><span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Background: </span></span></b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">The number of follicles aspirated during intracytoplasmic sperm injection (ICSI)/in vitro fertilization (IVF) treatment does not always match the number of oocytes recovered. </span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Objective:</span></span></b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times=""> This study aimed to assess the oocyte retrieval rate (ORR) distribution data and investigate the risk factors for low ORR in polycystic ovary syndrome (PCOS) cases undergoing IVF/ICSI.</span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Materials and Methods: </span></span></b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">This </span></span><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">prospective cohort study was conducted on 140 women aged between 18 and 40 yr with PCOS who were referred to Arash hospital in Tehran, Iran for ICSI/IVF treatment from March to November 2024. The ratio of obtained oocytes to follicles (&ge; 17 mm) on the trigger day was used to determine the OPR. 140 women were split into 2 groups: one with a low ORR and one with a normal ORR, each separated by one standard deviation from the ORR mean. </span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Results: </span></span></b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">No significant difference was observed between the low and normal ORR groups for progesterone levels. A statistically significant difference was observed in terms of estradiol/follicle ratio above 17, number of follicles above 17, and number of retrieved eggs between the low and normal ORR groups. Logistic regression analysis showed that serum estradiol/follicle ratio (&ge; 17 mm) with (OR = 0.96, 95% CI [0.94-0.98], p = 0.001) was a factor affecting low ORR.</span></span></span></span></span><br> <b><span style="font-size:12.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">Conclusion:</span></span></span></b><span style="font-size:12.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times=""> Low ORR, which results in fewer embryos and more cycle cancellations, may be caused by low progesterone levels on the trigger day, low estradiol levels/follicles (&ge; 17 mm), and the use of the progestin-primed regimen in PCOS cases.</span></span></span></div> لقاح آزمایشگاهی, تخمک, سندرم تخمدان پلی‌کیستیک, پروژسترون, استرادیول. Fertilization in-vitro, Oocyte, Polycystic ovary syndrome, Progesterone, Estradiol. 437 446 http://ijrm.ir/browse.php?a_code=A-10-2976-1&slc_lang=en&sid=1 Nahid Bahrami forouzanbahrami2010@gmail.com 0000-0002-5148-9905 No Department of Obstetrics and Gynecology, School of Medicine, Arash Women's Hospital, Vali-E-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran. Ashraf Moini ashraf_moini@tums.ac.ir 0000-0002-5074-2286 Yes Department of Obstetrics and Gynecology, School of Medicine, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran. Ladan Kashani ladan.kashani@gmail.com 0000-0002-9832-5625 No Department of Obstetrics and Gynecology, School of Medicine, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mahshad Khodarahmian mahshad.khodaramian@gmail.com 0009-0004-1751-8436 No Department of Obstetrics and Gynecology, School of Medicine, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran.