Ovarian response prediction index (ORPI): A novel biomarker for ovarian response prediction in IVF cycle: An implication for individualized controlled ovarian stimulation programme

Abstract

Background: The success of IVF depends to a large extent on the number and quality of mature oocytes obtained at the time of oocyte retrieval after controlled ovarian stimulation. This can be done by correctly predicting the ovarian response, which largely depends on ovarian reserve. The objective of present study was to assess accuracy of novel biomarker Ovarian Response Prediction Index (ORPI) based on three parameters patient age, AFC, AMH for prediction of ovarian response, so, we would be able to formulate individualized controlled ovarian stimulation approach to optimize cycle outcome. Methodology: This retrospective analysis was performed at our centre involving 100 patients undergoing IVF cycle between August 2019 and February 2020. We calculated ORPI by the following equation: ORPI = (AMH × AFC)/patient age, which was derived by Oliveira et al. Results: There was significant (p = 0.0001) positive correlation of ORPI with AFC, AMH, oocyte, MII oocyte and Embryo (gr1+2). ROC curve analysis showed that at ORPI cut off >0.18 (AUC 0.94) has sensitivity and specificity of 95.7% and 85.7%, respectively, for prediction of ≥4 oocyte recovery, and at cut off >2 (AUC 0.91) has sensitivity and specificity 75% and 85.2%, respectively, for prediction of ≥15 oocyte recovery. This study has demonstrated that for collection of ≥4 MII oocytes, ORPI at cut off >0.50 (AUC 0.86) has sensitivity and specificity of 74.1% and 78.9%, respectively. For probability of collection of >6 good quality embryos, we found ORPI cut off >0.75 with sensitivity and specificity of 72.7% and 64.2%, respectively. Conclusion: This study demonstrated that ORPI, which is simple 3 variable index, has shown excellent ability to predict low and excessive ovarian response and can be useful to tailor individualized controlled ovarian stimulation programme and will be beneficial for counselling and prognostication of infertile couple.