基础FSH水平升高并非排除体外受精-胚胎移植治疗的指标  

Elevated Follicle-stimulating Hormone Levels Can not be Considered as an MarkerIndex to Exclude in vitro Fertilization-Embryo Transfer Treatment

作　　者：陈士岭[1] 罗燕群[1] 陈薪[1] 夏容[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,广州510515

出　　处：《生殖与避孕》2011年第7期481-487,共7页Reproduction and Contraception

基　　金：国家重点基础研究发展规划课题(973课题)2007CB948104;国家自然科学基金(30470657);广东省中国科学院全面战略合作项目(2010B09031026)

摘　　要：目的:探讨基础卵泡刺激素(bFSH)水平升高是否为排除体外受精-胚胎移植(IVF-ET)治疗的指标。方法:回顾性分析3 498个取卵周期,按年龄分3组(<35周岁、35～39周岁、≥40周岁),再以bFSH水平不同细分A组(FSH≤9.99 IU/L)、B组(FSH 10.00～14.99 IU/L)、C组(FSH 15.00～19.99 IU/L)和D组(FSH≥20.00 IU/L)4个亚组,比较获卵数、临床妊娠率等多项指标的差异。结果:年龄<35岁、35～39岁和年龄≥40岁3组中B组、C组和D组患者的基础窦状卵泡数和获卵数明显低于A组,Gn总量和周期取消率明显高于A组,而受精率和卵裂率无明显统计学意义。年龄<35岁者中,A组、B组、C组、D组的临床妊娠率分别为47.8%、40.0%、26.3%、31.6%(P<0.05),活产率分别为40.2%、31.5%、21.1%、31.6%(P<0.05);年龄35～39岁时,A组、B组、C组、D组的临床妊娠率分别为39.7%、31.1%、22.7%、23.1%(P>0.05),活产率分别是28.5%、20.4%、18.2%、15.4%(P>0.05);年龄≥40岁时,A组、B组、C组、D组的临床妊娠率分别是15.5%、5.3%、8.3%、0%(P>0.05),活产率分别是11.0%、2.6%、8.3%、0%(P>0.05)。结论:bFSH≥10 IU/L时,提示卵巢储备功能和卵巢反应性减低,需增大促排卵治疗的Gn剂量,对于<40岁的不孕妇女,其FSH10～20 IU/L亦能获得较好的临床妊娠率,但bFSH>20 IU/L,亦获得了临床妊娠,故bFSH升高并非排除IVF治疗的指标。Objective： To explore whether increased follicle-stimulating hormone（FSH） levels can be considered as an index to abandon IVF-ET treatment.Methods： A total of 3 498 IVF/ICSI-ET cycles were analyzed retrospectively.They were divided into 3 groups according to the age（35 years,35-39 years,≥40 years）,three groups were further stratified into 4 subgroups according to basal FSH（bFSH） level： group A（≤9.99 IU/L）,group B（10.00-14.99 IU/L）,group C（15.00-19.99 IU/L） and group D（≥20.00 IU/L）.The clinic characteristics and outcomes such as amount of oocytes retrieved and clinical pregnancy rate were compared among 4 subgroups.Results： Compard with subgroup A,the patients in subgroups B,C,D had higher cancellation rate,requiring more total gonadotropins,but having less AFC and oocytes,there was no significant difference in the rate of fertilization and cleavage among 4 subgroups.In the young patinets group（〈35 years old）,the pregnancy rates of subgroups A,B,C and D were 47.8%,40.0%,26.3%,31.6%,respectively（P〉0.05）,and live birth rate were 40.2%,31.5%,21.1%,31.6%,respectively（P〉0.05）.In the older group（35-39 years old）,the pregnancy rates of subgroups A,B,C and D were 39.7%,31.1%,22.7%,23.1%,respectively（P〉0.05）,and live birth rate were 28.5%,20.4%,18.2%,15.4%,respectively（P〉0.05）,In the oldest group（≥40 years old）,the pregnancy rates of subgroups A,B,C and D were 15.5%,5.3%,8.3%,0%,respectively（P〉0.05）,and live birth rate were 11.0%,2.6%,8.3%,0%,respectively（P〉0.05）.Conclusion： The increased bFSH level≥10 IU/L is associated with the poor ovarian response to Gn.Females with bFSH level being higher than 10 IU/L need more Gn during the ovarian stimulation treatment.Females younger than 40 years old with bFSH level between 10 IU/L to 20 IU/L can get certain pregnancy rate,but it was oberved that the patients younger than 40 years old with bFSH level higher than 20 IU/L also obtained cinlcal pregnancy.Thus,high bFSH levels can not be

关 键 词：基础卵泡刺激素(bFSH) 妊娠率 IVF-ET 

分 类 号：R714.8[医药卫生—妇产科学]