Ovariální hyperstimulační syndrom v programu asistované reprodukce - analýza rizikových faktorů pomocí systému pro dolování znalostí z databází

BACKGROUND: Aim of the study is to define the risk factors of ovarian hyperstimulation syndrome onset during assisted reproduction treatment using in vitro fertilization technique. Exploratory computer analysis of electronically stored data about assisted reproduction treatment cycles in clinical registry with the use of data mining system. MATERIALS: Analyzed file included data of 12 527 monitored cycles from 1982 to 2004. Cycles which leaded to development of ovarian hyperstimulation syndrom were analyzed (2456 cases, 19,6 % of cycles). METHODS: Both the ovarian hyperstimulation syndrome complicated cases and cases without ovarian hyperstimulation were tested by data mining method which is designed to find statistically significant differences among input attributes of ovarian stimulation phase of therapeutic cycles. The observed differences between input attributes were statistically tested and the value of statistical significance was evaluated. RESULTS: Significantly higher incidence of a clinically important form of ovarian hyperstimulation syndrome development was observed among patients under 30 years old who were affected by hyperstimulation syndrome in previous treatment cycles. We can predict a higher risk in patients with oligomenorrhoea and in cases of immunological and andrological sterility factor. Higher incidence of clinically significant form of hyperstimulation syndrome is noticed with stimulation protocols with highly effective gonadotrophine hormones where the total dose of gonadotrophins is greater than 1125 IU and maximum 17-beta estradiol levels are greater than 20 nmol/l. CONCLUSIONS: We have proved the applicability of the data mining system for the analysis of the risk factors with influence on the Assisted reproduction treatment results. Data mining method can be used to define statistically significant relations among all attributes of ovarian stimulation part of therapeutic cycle and to define the risk factors of hyperstimulation syndrome occurrence.