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作 者:王俊霞[1] 孙海翔[1] 王玢[1] 张宁媛[1] 陈华[1] 胡娅莉[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,南京210008
出 处:《生殖医学杂志》2010年第6期490-493,共4页Journal of Reproductive Medicine
摘 要:目的探讨年龄、基础卵泡刺激素(bFSH)及基础窦卵泡数(antral follicle count,AFC)预测卵巢反应性的价值。方法回顾性分析本中心2003年1月至2009年7月5,453例应用长方案行体外受精/卵胞浆内单精子注射-胚胎移植(IVF/ICSI-ET)患者的临床资料。结果 (1)年龄、bFSH与外源性促性腺激素(Gn)用量呈显著正相关,AFC与Gn用量呈显著负相关(r分别为0.364、0.325和-0.450)。年龄、bFSH与成熟卵泡数呈显著负相关,AFC与成熟卵泡数呈显著正相关(r分别为-0.285、-0.299和0.516)。AFC与Gn用量及成熟卵泡的相关性均最密切。(2)年龄、bFSH与AFC预测卵巢低反应的ROC曲线下面积AUC_1、AUC_2、AUC_3分别为0.68、0.69、0.85,均显著>参考下面积(P均<0.05);AUC_3均大于AUC_1及AUC_2,差异有统计学意义(Z_(13)=9.42,Z_(23)=7.28,P均<0.05),AUC_1及AUC_2比较无显著差异(Z_(12)=0.46,P>0.05)。结论年龄、bFSH、AFC均可以预测卵巢反应性,且AFC的预测价值优于bFSH及年龄。Objective: To investigate the value of age, basal follicle-stimulating hormone (bFSH) and antral follicle count (AFC) in the prediction of ovarian response in women undergoing in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI ET) Methods: The clinical data of 5,453 long protocol IVF/ICSI-ET cycles in this hospital from January 2003 to July 2009 were analyzed retrospectively. Results: (1) The age and bFSH levels were positively correlated and AFC inversely correlated with gonadotropin ampoules (r=0. 364, 0. 325, and -0. 450, P〈0.05, respectively). The age and bFSH levels were inversely related and AFC positively related to the number of mature follicles (r =-0. 285, -0. 299 and 0. 516, P〈0.05, respectively). Among these parameters, AFC was most correlated with ovarian response; (2) The areas under ROC curve (AUC) of age, bFSH and AFC were 0.68 (AUCl) , 0.69 (AUC2) and 0.85 (AUC3), respectively, and all were larger than those under the diagnosis reference line for predicting the poor response (P〈0.05). AUC3 was significantly larger than AUC1 and AUC2 (Z13 = 9.42 and Z23=7.28, P〈0.05, respectively), and there was no significant difference between AUC1 and AUC2 (Z12 =0.46, P〉0.05). Conclusions: Age, bFSH and AFC are all valuable in the prediction of ovarian response, and AFC is the best predictor of all three.
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