应用ROC曲线评估年龄、窦卵泡数及基础卵泡刺激素预测卵巢储备功能的价值  

Evaluating the predictive value of age,AFC and bFSH on ovarian reserve function by receiver operating characteristic analysis

作　　者：王俊霞[1] 孙海翔[1] 王玢[1] 侯晓妮[1] 朱静静[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：《现代妇产科进展》2011年第10期784-787,共4页Progress in Obstetrics and Gynecology

摘　　要：目的:探讨年龄、窦卵泡数(antral follicle count,AFC)、基础卵泡刺激素(bF-SH)预测卵巢储备功能的价值。方法:应用受试者工作特征曲线(ROC),回顾性分析本中心2003年1月～2009年12月6387例应用长方案行体外受精/卵细胞内单精子注射-胚胎移植(IVF/ICSI-ET)患者的临床资料。结果:(1)年龄、AFC与bFSH预测卵巢低反应的ROC曲线下面积AUCl、AUC2、AUC3分别为0.69、0.86、0.70,均大于机会参考线下面积(P<0.05),AUC2大于AUCl及AUC3,差异有统计学意义(Z12=9.43,Z23=8.21,P均<0.05),AUCl及AUC3差异无统计意义(Z13=0.35,P>0.05)。(2)年龄、AFC与bFSH预测临床妊娠的ROC曲线下面积AUC4、AUC5、AUC6分别为0.57、0.55、0.53,均大于机会参考线下面积(P<0.05),AUC4大于AUC5及AUC6,差异有统计学意义(Z45=2.21,Z46=3.98,P均<0.05),AUC5与AUC6差异无统计意义(Z56=1.77,P>0.05)。(3)AUCl值、AUC2值、AUC3均分别显著大于AUC4、AUC5、AUC6(Z14=7.18,Z25=24.75,Z36=9.31,P均<0.05)。结论:年龄、AFC及bFSH均能预测卵巢的储备功能。对于卵巢低反应的预测价值,AFC高于年龄及bFSH。对于临床妊娠的预测价值,年龄高于AFC及bFSH。且年龄、AFC及bFSH对卵巢低反应的预测价值均高于对临床妊娠的预测价值。Objective：To evaluate the predictive value of age,AFC and bFSH on ovarian reserve function in women undergoing in vitro fertilization and embryo transfer.Methods：6387 long protocol IVF/ICSI-ET cycles from Jan.2003 to Dec.2009 were analyzed retrospectively by ROC curve.Results：（1）The areas under ROC curve（AUC）of age,AFC and bFSH for predicting the poor response rate were 0.69（AUCl）,0.86（AUC2）,and 0.70（AUC3）respectively,which were all larger than the areas under the diagnosis reference line（P0.05）.AUC2 was significantly larger than AUCl and AUC3（Z12=9.43,Z23=8.21,P0.05）,and there was no significant difference between AUCl and AUC3（Z13=0.35,P0.05）.（2）The AUC of age,AFC and bFSH for predicting the clinical pregnancy rate were 0.57（AUC4）,0.55（AUC5）,and 0.53（AUC6）respectively,which were all larger than those under the diagnosis reference line（P0.05）.AUC4 was significantly larger than AUC5 and AUC6（Z45=2.21,Z46=3.98,P0.05）,and there was no significant difference between AUC5 and AUC6（Z56=1.77,P0.05）.（3）AUCl,AUC2 and AUC3 were separately larger than AUC4,AUC5,and AUC6（Z14=7.18,Z25=24.75,Z36=9.31,P0.05）.Conclusions：Age,bFSH and AFC are all valuable in prediction of ovarian reserve function,whereas AFC achieves the better value in predicting ovarian response than age and bFSH.Age is better at predicting the clinical pregnancy than AFC and bFSH.Age,AFC and bFSH are better at predicting the poor response to gonadotrophin stimulation than the chance of pregnancy.

关 键 词：年龄 窦卵泡数 基础卵泡刺激素 卵巢储备功能 受精 体外 胚胎移植 

分 类 号：R711.6[医药卫生—妇产科学]