垂体降调节后血清FSH值及FSH/LH比值预测卵巢反应性及助孕结局的价值  

Predictive value of the serum FSH and FSH/LH ratio after pituitary down-regulation in IVF

作　　者：郑娟[1] 周黎明[1] 孙亦婷[1] 赵雅云[1] 夏爱丽[1] 

机构地区：[1]浙江宁波市妇女儿童医院,宁波市315012

出　　处：《生殖医学杂志》2013年第8期569-572,共4页Journal of Reproductive Medicine

基　　金：宁波市自然科学基金项目(2011A610035)

摘　　要：目的探讨在控制性超排卵(COH)治疗中,垂体降调节后血清卵泡刺激素(FSH)值及其与黄体生成素(IH)比值在预测卵巢反应性中的价值。方法回顾性分析我中心使用短效促性腺激素释放激素激动剂(GnRH-a)对垂体进行降调节的487个体外受精-胚胎移植(IVF-ET)周期。于开始降调节后第15天检测血清FSH及LH水平,并计算FSH/LH比值,分析FSH值及FSH/LH比值与获卵数目的相关性;按照FSH值及FSH/LH比值分别进行分组,比较各组间促性腺激素(Gn)天数、Gn总剂量、获卵数、优质胚胎率及临床妊娠率等指标间的差异。结果 (1)FSH值及FSH/LH比值与获卵数目均呈负相关(分别为r=-0.26;r=-0.18)。(2)按照FSH值分组:FSH≤3U/L组获卵数(12.51±5.97)显著高于FSH>3U/L组(10.49±5.26)(P<0.01),但两组间Gn天数、Gn总剂量、优质胚胎率及临床妊娠率等指标均无统计学差异(P>0.05)。(3)根据FSH/LH分组为FSH/LH≤1组、1<FSH/LH≤2组、2<FSH/LH≤3组、3<FSH/LH≤4组及FSH/LH>4组,各组获卵数目分别为(8.12±4.29)、(12.63±5.72)、(11.1 3±4.89)、(10.60±4.23)及(10.22±3.98),其中1<FSH/LH≤2组显著高于其他组(P<0.05);1<FSH/LH≤2组及2<FSH/LH≤3组Gn天数及Gn总剂量均显著小于其他组(P<0.05),而优质胚胎率及临床妊娠率等均显著高于其他组(P<0.05)。结论降调节后血清FSH值及FSH/LH比值能够较好地预测卵巢反应性及助孕结局,降调节后1<FSH/LH≤3时临床妊娠率最高。Objective： To investigate the relationship of FSH level in serum and the ratio of FSH/LH to ovarian response in women undergoing pituitary down-regulation and controlled ovarian hyper-stimulation （COH）. Methods： The data of patients undergoing pituitary down-regulation by using short-acting gonadotropin releasing hormone agonist （GnRH-a） in total 487 IVF-ET cycles were retrospectively analyzed. The levels of FSH and LH in serum on the 15th day after beginning using GnRHa were detected. The relationship between the FSH level and the result of COH, and between the ratios of FSH/LH and the result of COH were analyzed. All cycles were divided into two groups according to the FSH level （FSH ≤3U/L group andFSH〉 3U/L group） and five groups according to FSH/LH （FSH/LH≤1 group, 1〈FSH/LH≤ 2 group, 2〈FSH/LH≤3 group, 3〈FSH/LH≤4 group and FSH/LH〉4 group）. The days of giving gonadotropin, the dose of gonadotropin, the numbers of retrieved oocytes, the rate of embryo in high quality and the rate of clinical pregnancy were compared among the groups.（1） The FSH level and the ratio of FSH/LH on the 15th day after beginning using GnRH-a were negatively correlated to the number of retrieved oocytes （r=-0.26 and r=-0.18, respectively）. （2） In FSH 〉3U/L group, the number of retrieved oocytes （10.49±5.26）was significantly less than that in FSH≤3U/L group （12.51±5.97） （P〈0.01）. （3） In the fire groups, number of retrieved oocytes was （8.12±4. 29）, （12.63 ±5.72）, （11.13 ±4. 89）, （10. 60± 4.23） and （10.22 ± 3.98） respectively, and 1〈FSH/LH≤ 2 group produced the most number of retrieved oocytes （P〈 0. 05）. The days of gonadotropin usage were （9.20±1.87）, （8. 97±1.35）, （9. 01±1.79）, （9.44±1.68） and （9.29±1.45） respectively. The amps of gonadotropin used were（27. 90 ±9. 10）, （23. 51± 7.50）, （24. 94± 7.21）, （28.56± 8. 65）and（26. 90±8. 13）respectively. The rate of embryo in high quality

关 键 词：卵泡刺激素 黄体生成素 控制性超排卵 垂体降调节 

分 类 号：R[医药卫生]