卵泡发育与控制性卵巢刺激卵巢储备功能与反应性评估

刘婧, 万鹏程, 全松

中国实用妇科与产科杂志 ›› 2025, Vol. 41 ›› Issue (12) : 1157-1161.

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中国实用妇科与产科杂志 ›› 2025, Vol. 41 ›› Issue (12) : 1157-1161. DOI: 10.19538/j.fk2025120102
专题笔谈

卵泡发育与控制性卵巢刺激卵巢储备功能与反应性评估

作者信息 +

Assessment of ovarian reserve and responsiveness

Author information +
文章历史 +

摘要

卵巢储备功能与反应性密切相关,其评估是辅助生殖技术中控制性卵巢刺激的前提。评估卵巢储备功能和反应性的指标包括:年龄、生化指标、超声检查窦状卵泡计数等,上述指标既可单独应用又可联合应用评估卵巢储备功能和反应性。目前,人工智能技术通过整合多模态数据来优化卵巢储备功能和反应性的评估与预测,弥补传统评估方法的局限性,展示出良好的应用前景。

Abstract

Ovarian reserve function is closely associated with ovarian responsiveness,and its assessment is a prerequisite for controlled ovarian stimulation in assisted reproductive technology.Indicators for evaluating ovarian reserve and responsiveness include age,biochemical indicators,and ultrasound-measured antral follicle count(AFC),etc.These indicators can be used either individually or in combination to assess ovarian reserve and responsiveness.Currently,a.jpgicial intelligence(AI)technology is used to optimize the evaluation and prediction of ovarian reserve and responsiveness by integrating multimodal data,compensating for the limitations of traditional assessment methods and demonstrating promising application prospects.

关键词

卵巢储备功能 / 卵巢反应性 / 生化指标 / 超声检查 / 人工智能

Key words

ovarian reserve function / ovarian responsiveness / biochemical indicators / ultrasound examination / a.jpgicial intelligence

引用本文

导出引用
刘婧, 万鹏程, 全松. 卵泡发育与控制性卵巢刺激卵巢储备功能与反应性评估[J]. 中国实用妇科与产科杂志. 2025, 41(12): 1157-1161 https://doi.org/10.19538/j.fk2025120102
LIU Jing, WAN Peng-cheng, QUAN Song. Assessment of ovarian reserve and responsiveness[J]. Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(12): 1157-1161 https://doi.org/10.19538/j.fk2025120102
中图分类号: R711.6   

参考文献

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The age-related decline of fertility is caused by a reduction of the ovarian reserve, which is represented by the number and quality of oocytes in the ovaries. Anti-Müllerian hormone (AMH) is considered one of the most useful markers of the quantity of the ovarian reserve; however, a more accurate prediction method is required. Furthermore, there is no clinically useful tool to assess the quality of the ovarian reserve and therefore a prediction tool is required. Our aim is to produce a model for prediction of the ovarian reserve that contributes to preconception care and precision medicine.This study was a retrospective analysis of 442 patients undergoing assisted reproductive technology (ART) treatment in Japan from June 2021 to January 2023. Medical records and residual serum of patients undergoing oocyte retrieval were collected. Binary classification models predicting the ovarian reserve were created using machine learning methods developed with many collected feature values. The best-performing model among 15 examined models was selected based on its area under the receiver operating characteristic curve (AUC) and accuracy. To maximize performance, feature values used for model creation were narrowed down and extracted.The best-performing model to assess the quantity of the ovarian reserve was the random forest model with an AUC of 0.9101. Five features were selected to create the model and consisted of data from only medical records. The best-performing model to assess the quality of the ovarian reserve was the random forest model, which had an AUC of 0.7983 and was created with 14 features, data from medical records and residual serum analysis.Our models are more accurate than currently popular methods for predicting the ovarian reserve. Furthermore, they can assess the ovarian reserve using only information obtained from a medical interview and single blood sampling. Enabling easy measurement of the ovarian reserve with this model would allow a greater number of women to engage in preconception care and facilitate the delivery of personalized medical treatment for patients undergoing infertility therapy.Not applicable.© 2025. The Author(s).
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Individualizing follicle-stimulating hormone (FSH) dosing during controlled ovarian stimulation (COS) is critical for optimizing outcomes in assisted reproduction but remains difficult due to patient heterogeneity. Most existing models are limited to static predictions of initial doses and do not support real-time adjustments throughout stimulation.We developed a deep learning model that integrates cross-temporal and cross-feature encoding (CTFE) to predict personalized daily FSH doses in patients undergoing COS using the GnRH agonist long protocol. A total of 13,788 IVF/ICSI cycles conducted between January 2018 and December 2020 were retrospectively analyzed. Women with baseline antral follicle counts between 7 and 30 were included. Data were randomly divided into training (n = 6761), validation (n = 2898), and test (n = 4135) sets. The model encodes both static (e.g., age, BMI, basic hormone levels) and dynamic (e.g., follicle development, hormone trends during COS) variables across stimulation days. Final dose predictions were generated using a K-nearest neighbor algorithm applied to low-dimensional latent representations derived from the deep encoder layers.The CTFE model achieved a dose classification accuracy of 0.737 (± 0.004) and a weighted F1-score of 0.732 (± 0.005) on the test set. On key stimulation days 1 and 5, the CTFE model significantly outperformed traditional LASSO regression models (F1-score: 0.832 vs 0.699 on day 1; 0.817 vs 0.523 on day 5; p < 0.001). Prediction performance was maintained beyond day 13 using a sliding window mechanism, despite reduced data availability in longer stimulation cycles.This is the first study to apply a cross-temporal and cross-feature deep learning framework for daily, individualized FSH dose prediction across the full duration of COS. The model demonstrated superior performance over conventional approaches and offers a promising tool for standardizing COS management. Although currently limited by its retrospective, single-center design, the model may support future clinical decision-making and improve COS outcomes. Prospective, multicenter validation studies are warranted to confirm its utility and generalizability.© 2025. The Author(s).
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国家自然科学基金(82171656)

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