年龄和基础血清卵泡刺激素浓度对预测体外受精和胚胎移植结局的价值  

Effects of maternal age and basal serum FSH on predicting the prognosis of in vitro fertilization and embryo transfer

作　　者：庹平[1] 王文军[1] 欧阳能勇[1] 陈静华[1] 马芸[1] 麦美琪[1] 

机构地区：[1]中山大学附属第二医院生殖中心,广州510120

出　　处：《广东医学》2010年第19期2489-2492,共4页Guangdong Medical Journal

摘　　要：目的评估和比较使用基础血清卵泡刺激素(bFSH)浓度和年龄对于预测体外受精和胚胎移植(IVF-ET)结局的临床价值。方法 1482个诊断为不孕不育行IVF-ET或者ICSI-ET的周期被纳入分析。lo-gistic回归分析用来探讨年龄和bFSH对活产率(主要的考察指标)的影响。结果高水平bFSH(>8.78IU/L)妇女在各个年龄组中的比例是逐渐增高的。在<30岁、>38岁2个年龄段活产率随着bFSH的升高而升高。当女性超过35岁,活产的优势下降50.3%(P<0.001)。而对于bFSH>8.78IU/L,≥10IU/L,≥11IU/L,≥13IU/L的女性与各自其他的女性相比,活产的优势分别下降43.6%(P=0.006)、59.6%(P=0.004)、62.8%(P=0.01)、79.8%(P=0.03)。而>38岁且bFSH≤8.78IU/L与<30岁且bFSH>8.78IU/L的女性比较,活产优势下降85.1%。结论年龄较bFSH浓度能更好地预测IVF的生育结局,但是年龄并不能用来单独预测,因为在年长的妇女中活产率似乎随着bFSH的升高而升高。Objective To assess the clinical value of maternal age and basal serum FSH（bFSH）in predicting the prognosis of IVF-ET.Methods One thousand four hundred and two cases diagnosed as infertility received IVF-ET or ICSI-ET were enrolled.Logistic regression analysis was used to determine the correlation between maternal age or FSH and live birth rate（LBR）.Results The proportion of women with high level bFSH（bFSH8.78IU/L）increased following an age-dependent manner.The LBR increased with high bFSH level in women younger than 30 years and elder than 38 years old.Significant decrease by 50.3% in live birth rate was observed in women not younger than 35 years old（P0.001）.The live birth rate was significantly reduced by 43.6%（P=0.006）,59.6%（P=0.004）,62.8%（P=0.01）and 79.8%（P=0.03）in women with bFSH 8.78IU/L,≥10IU/L,≥11IU/L and ≥13IU/L comaring with the other subjects.In women over 38 years with bFSH8.78IU/L,it was reduced by 85.1% compared with that in women younger than 30 years with bFSH8.78IU/L.Conclusion It is better to use age than bFSH to foresee the outcome of IVF-ET,but age can not predict it alone because the LBR seems increasing with elevated bFSH in older women.It is suggested that maternal age provide more efficacy in predicting prognosis in IVF-ET than bFSH level.However,in aged women bFSH increase indicates an improve of live birth rate.

关 键 词：体外受精-胚胎移植 年龄因素 基础血清卵泡刺激素 活产率 

分 类 号：R711.75[医药卫生—妇产科学]