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Revisiting the role of serum progesterone as a test of ovulation in eumenorrheic subfertile women: a prospective diagnostic accuracy study
Fertility and Sterility ( IF 6.6 ) Pub Date : 2020-12-01 , DOI: 10.1016/j.fertnstert.2020.06.030
Parimala Chinta 1 , Grace Rebekah 2 , Aleyamma T Kunjummen 1 , Mohan S Kamath 1
Affiliation  

OBJECTIVE To estimate the prevalence of ovulatory cycles in eumenorrheic subfertile women and compare the diagnostic accuracy of a single ultrasound with serum midluteal progesterone measurement in detecting ovulatory cycles. DESIGN Prospective diagnostic accuracy study. SETTING University-level hospital. PATIENT(S) A total of 208 subfertile eumenorrheic women. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) To estimate the prevalence of ovulatory cycles in eumenorrheic women and compare the diagnostic accuracy of a single, well-timed ultrasound scan (index test) with serum progesterone measurement (reference test) by calculating the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and positive likelihood ratio (LR+) and negative likelihood ratio (LR-). RESULT(S) The prevalence of ovulatory cycles among subfertile eumenorrheic women was 92.9% and 99.5% when midluteal serum progesterone level and ultrasound scanning were used as the reference test, respectively. The sensitivity, specificity, PPV, and NPV of ultrasound in identifying ovulatory cycles were 100%, 7.1%, 93.4%, and 100%, respectively. The LR+ and LR- were 1.1 and 0, respectively. The agreement between the ultrasound and serum progesterone was almost perfect (prevalence and bias-adjusted kappa = 0.81. CONCLUSION(S) The prevalence of ovulatory cycles in eumenorrheic subfertile women appears to be high. A single well-timed ultrasound can be performed to identify ovulatory cycles during the infertility workup in eumenorrheic women.

中文翻译:

重新审视血清孕酮作为月经不调不育女性排卵测试的作用:一项前瞻性诊断准确性研究

目的估计月经不调女性排卵周期的患病率,并比较单次超声与血清黄体中黄体酮测量在检测排卵周期方面的诊断准确性。设计前瞻性诊断准确性研究。设置 大学级医院。PATIENT(S) 共有 208 名不育的月经过多的女性。干预措施 无。主要结局指标 估计月经过多女性排卵周期的发生率,并通过计算敏感性、特异性、阳性结果来比较单次、适时的超声扫描(指标测试)与血清孕酮测量(参考测试)的诊断准确性预测值 (PPV)、阴性预测值 (NPV)、阳性似然比 (LR+) 和阴性似然比 (LR-)。结果 以黄体中期血清孕酮水平和超声扫描作为参考检测,不育性月经过多的女性排卵周期的发生率分别为92.9%和99.5%。超声识别排卵周期的敏感性、特异性、PPV 和 NPV 分别为 100%、7.1%、93.4% 和 100%。LR+和LR-分别为1.1和0。超声和血清黄体酮之间的一致性几乎是完美的(患病率和偏差调整的 kappa = 0.81。结论(S) 月经不育女性排卵周期的患病率似乎很高。可以进行一次适时的超声检查来识别月经过多女性不孕检查期间的排卵周期。以黄体中期血清孕酮水平和超声扫描分别作为参考试验时的5%。超声识别排卵周期的敏感性、特异性、PPV 和 NPV 分别为 100%、7.1%、93.4% 和 100%。LR+和LR-分别为1.1和0。超声和血清孕酮之间的一致性几乎是完美的(患病率和偏差调整后的 kappa = 0.81。结论(S) 月经不育女性排卵周期的患病率似乎很高。可以进行一次适时的超声检查来识别月经过多女性不孕检查期间的排卵周期。以黄体中期血清孕酮水平和超声扫描分别作为参考试验时的5%。超声识别排卵周期的敏感性、特异性、PPV 和 NPV 分别为 100%、7.1%、93.4% 和 100%。LR+和LR-分别为1.1和0。超声和血清黄体酮之间的一致性几乎是完美的(患病率和偏差调整的 kappa = 0.81。结论(S) 月经不育女性排卵周期的患病率似乎很高。可以进行一次适时的超声检查来识别月经过多女性不孕检查期间的排卵周期。分别为 1 和 0。超声和血清黄体酮之间的一致性几乎是完美的(患病率和偏差调整的 kappa = 0.81。结论(S) 月经不育女性排卵周期的患病率似乎很高。可以进行一次适时的超声检查来识别月经过多女性不孕检查期间的排卵周期。分别为 1 和 0。超声和血清黄体酮之间的一致性几乎是完美的(患病率和偏差调整的 kappa = 0.81。结论(S) 月经不育女性排卵周期的患病率似乎很高。可以进行一次适时的超声检查来识别月经过多女性不孕检查期间的排卵周期。
更新日期:2020-12-01
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