基础睾酮水平对卵巢储备功能下降患者体外受精-胚胎移植结局的预测  

Basal testosterone level has a predictive effect on the outcome of in vitro fertilization-embryo transfer in patients with diminished ovarian reserve

作　　者：聂明月 方颖[1] 张军[1] 马延敏[1] 刘英[1] 贾婵维[1] 王树玉[1] 杨晓葵[1] 

机构地区：[1]首都医科大学附属北京妇产医院生殖医学科,北京100026

出　　处：《中国优生与遗传杂志》2015年第3期96-98,共3页Chinese Journal of Birth Health & Heredity

基　　金：国家自然科学基金项目(81170542);北京市卫生系统高层次人才培养项目(2011-3-071);首都医科大学附属北京妇产医院学科带头人项目(2013-2)

摘　　要：目的探讨基础睾酮水平对卵巢储备功能下降（DOR）患者控制性超促排卵（COH）及体外受精/卵胞浆内单精子注射-胚胎移植（IVF/ICSI-ET）结局的预测作用。方法回顾性分析2010年1月~2013年8月于我院生殖中心应用Gn RH拮抗剂（Gn RH-ant）方案促排卵行IVF/ICSI助孕的DOR患者138例,探讨基础睾酮与COH各参数的相关性及对IVF妊娠结局的影响。结果 DOR患者妊娠组的基础睾酮水平、窦卵泡数、HCG日E2水平和获卵数显著高于未妊娠组（P〈0.05）;在相关分析中,体重指数、窦卵泡数及获卵数与基础睾酮水平呈正相关;ROC曲线显示,基础睾酮水平与DOR患者IVF妊娠结局存在相关性,曲线下面积为0.779（95%CI 0.704-0.855,P〈0.01）,基础睾酮的最佳界值为20.86ng/dl,敏感度81.8%,特异度61.9%。结论基础睾酮水平能较好地预测DOR患者IVF妊娠结局,当DOR患者基础T水平高于20.86ng/dl时临床妊娠率较高。Objective：To investigate the association of basal testosterone（b T）level with the outcome of controlled ovarian hyperstimulation and in vitro fertilization/intracytoplasmic sperm injection-embryo transfer（IVF/ICSI-ET）in patients with diminished ovarian reserve. Method：The effects of basal testosterone level on the outcome of IVF were retrospectively analyzed involved 138 patients undergoing IVF with Gn RH-ant protocol from January 2010 to August 2013.Results：In DOR patients,b T,antral follicle count,E2 levels on HCG day and the number of oocytes retrieved were significantly higher in the pregnancy group than that in the non-pregnancy group（P〈0.05）. By Spearman correlation,body mass index（BMI）,antral follicle count（AFC）and the number of oocytes retrieved were positively correlated with b T. The b T level presented a positive association with pregnancy outcome in DOR women by using receiver operating characteristic（ROC）analysis,area under the ROC is 0.779（95%CI 0.704-0.855,P〈0.01）and the cut-off value of b T was 20.86 ng/dl to predict patient as pregnancy after IVF-ET. The sensitivity and specificity were 81.8% and 61.9% respectively. Conclusion：In DOR women,b T is a predictive marker for IVF outcome. In addition,women with b T higher than 20.86 ng/dl have an increased pregnancy rate compared with those low b T levels.

关 键 词：基础睾酮 控制性超排卵 体外受精-胚胎移植 卵巢储备功能下降 

分 类 号：R714.8[医药卫生—妇产科学]