年轻妇女基础FSH高水平与卵子和胚胎的数量、质量及临床结局的关系  

Impact of elevated basal follicle-stimulating hormone on the quantity and quality of oocytes and embryos and pregnancy outcomes in young women

作　　者：陈士岭[1] 罗燕群[1] 夏容[1] 陈薪[1] 施晓鋆[1] 郑海燕[1] 王乐乐[1] 吴雅琴[1] 

机构地区：[1]南方医科大学南方医院妇产科生殖医学中心,广东广州510515

出　　处：《南方医科大学学报》2011年第5期777-781,共5页Journal of Southern Medical University

基　　金：国家"973"项目(2007CB948104);广东省自然科学基金(04020416)~~

摘　　要：目的探讨小于35周岁不孕妇女的基础卵泡刺激素(FSH)升高是否影响卵子和胚胎的数量、质量及其临床结局。方法回顾性分析294个年龄<35周岁的体外受精-胚胎移植治疗周期,按基础FSH水平分A组(10～14.99U/L)、B组(15～19.99U/L)和C组(FSH≥20U/L),比较获卵数、卵子和胚胎的形态学、临床结局等指标的差异。结果 B组和C组的获卵数、总胚胎数和优质胚胎数较A组低,促性腺激素总量较A组高;三组间成熟卵子率、卵裂球数目比例、正常受精率、卵裂率、优质胚胎率、种植率、临床妊娠率、活产率和早期流产率差异无统计学意义,基础FSH≥15U/L妇女的临床妊娠率和活产率有降低的趋势。结论小于35岁不孕妇女随基础FSH升高,尤其≥15U/L者,卵巢储备功能减退,卵子数和胚胎数明显减少,但卵子和胚胎质量未受影响,仍能获得相当好的临床妊娠率。Objective To evaluate the effect of elevated basal follicle-stimulating hormone（FSH） on both the quantity and quality of oocytes and embryos and the clinical outcomes of pregnancy in women under 35 years of age.Methods A retrospective analysis was conducted for inspecting 294 in vitro fertilization-embryo transfer（IVF-ET） cycles in women under 35 years of age.According to the basal FSH levels,the women were divided into groups A,B,and C with basal FSH of 10-14.99,15-19.99 and ≥20 IU/L,respectively,to compare the average number of oocytes retrieved,morphologies of the oocytes and embryos,and clinical outcomes of pregnancy.Results Group A showed greater average numbers of oocytes collected,total embryos and good-quality embryos with a lower gonadotrophin dose required to achieve follicular maturity than groups B and C.The 3 groups showed no significant differences in the percentage of metaphate II oocytes,optimal embryos-blastomere number,normal fertilization rate,cleavage rate,good-quality embryo rate,implantation rate,pregnancy rates,live birth rate or miscarriage rate,but the pregnancy rates and live birth rate tended to decrease in women with basal FSH ≥15 U/L.Conclusion In women below 35 years of age,an elevated serum FSH（especially one ≥15 U/L） indicates diminished ovarian reserve and reduced numbers of oocyte and embryo but not poor oocyte or embryos quality,and good clinical pregnancy rate can still be expected.

关 键 词：基础FSH 胚胎质量 体外受精-胚胎移植 

分 类 号：R714.8[医药卫生—妇产科学]