年龄联合基础卵泡刺激素对体外受精-胚胎移植患者卵巢储备功能的预测价值  

Female age and basal FSH predict ovarian reserve and pregnancy in women undergoing in vitro fertilization and embryo transfer

作　　者：王俊霞[1] 孙海翔[1] 胡娅莉[1] 王玢[1] 张宁媛[1] 陈华[1] 

机构地区：[1]南京大学医学院附属鼓楼医院生殖医学中心,江苏南京210008

出　　处：《中国实用妇科与产科杂志》2009年第11期833-836,共4页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的探讨年龄联合基础卵泡刺激素(bFSH)预测卵巢储备功能的价值。方法回顾性分析南京大学鼓楼医院生殖医学中心2003年1月至2007年12月3438周期应用长方案行体外受精-胚胎移植患者的临床资料。根据患者年龄分为4组:<35、35～、38～、41～岁组。根据bFSH值分为2组:<8IU/L组与≥8IU/L组。根据年龄与bFSH分为4组:年龄<38岁且bFSH<8IU/L、年龄<38岁且bFSH≥8IU/L、年龄≥38岁且bFSH<8IU/L、年龄≥38岁且bFSH≥8IU/L组。结果随年龄增加,周期取消率、促性腺激素(Gn)用量逐渐增加,而获卵数逐渐减少。临床妊娠率及分娩率随年龄增加而降低(各组分别为62.7%、53.2%、42.1%、26.1%和52.7%、41.4%、31.4%、13.0%,P<0.05)。在两个年龄组(年龄<38岁与年龄≥38岁)中,bFSH≥8IU/L组的周期取消率、Gn用量显著高于bFSH<8IU/L组(P<0.05),获卵数、可移植胚胎数显著低于bFSH<8IU/L组(P<0.05),而种植率、临床妊娠率、流产率以及分娩率与bFSH<8IU/L组比较差异无统计学意义(P>0.05)。结论随着年龄的增长,卵母细胞数量和质量下降,即卵巢储备功能下降。在同一年龄组中,随着bFSH水平增高卵母细胞数目减少,而卵母细胞质量并未降低。年龄结合基础FSH能够对卵巢储备功能进行更确切的评价。Objective To investigate the predictive value of female age and basal FSH on ovarian reserve in women undergoing in vitro fertilization and embryo transfer. Methods 3438 long protocol IVF/ICSI -ET cycles between January 2003 and December 2007 were analyzed retrospectively. All cases were divided into four groups according to female age ： 〈35,35 - ,38 - and ≥41 years. All cases were divided into two groups according to FSH levels： 〈 8 IU/ L and ≥ 8IU/L. All cases were divided into four groups according to female age and FSH levels： 〈 38 years and bFSH 〈 8 IU/ L, 〈38 years and bFSH ≥8 IU/ L, ≥38 years and bFSH 〈8 IU/L, ≥38 years and bFSH ≥8 IU/ L. Results With the age growing, the cycle cancellation rate and number of Gn in each group increased, and oocytes collected decreased. The pregnancy rate and live birth rate were significantly lower（62.7% ,53.2% ,42. 1% ,26. 1% and 52. 7% , 41.4% ,31.4% ,13.0% , respectively, P 〈 0. 05 ）. Both in the younger （ 〈 38 years） and the older groups （ ≥ 38 years）, higher levels of FSH were significantly associated with more cycle cancellation, a larger amount of Gn required and a lower number of oocytes collected, embryos available; there was no significant difference between the two FSH groups as to the implantation rate, miscarriage rate, pregnancy rate and live birth rate. Conclusion With the age growing, the oocyte number and quality decreased. High FSH reflects reduced oocyte number but not poor oocyte quality. Female age and basal FSH can be used together to predict the ovarian response in women undergoing in vitro fertilization and embryo transfer.

关 键 词：年龄 基础卵泡刺激素 卵巢储备功能 体外受精-胚胎移植 

分 类 号：R71[医药卫生—妇产科学]