基础FSH/LH比值对IVF-ET临床结局的预测价值  

Predictive values of ratio of basal FSH/LH on outcome of IVF-ET

作　　者：刘颖[1] 姜宏[1] 

机构地区：[1]中国人民解放军第105医院生殖医学中心,合肥230031

出　　处：《生殖医学杂志》2015年第7期551-554,共4页Journal of Reproductive Medicine

摘　　要：目的探讨不同年龄阶段不孕不育患者血清基础卵泡刺激素/基础黄体生成素（bFSH/bLH）比值对体外受精-胚胎移植（IVF-ET）临床结局的预测价值。方法回顾性分析2011年1月至2013年12月我中心接受IVF-ET或卵胞浆内单精子注射（ICSI）的1 301个周期的临床资料,根据患者年龄和bFSH/bLH比值,分为A、B、C、D 4组：A组：年龄〈35岁（A1亚组：bFSH/bLH≥2,n=300;A2亚组：bFSH/bLH〈2,n=692）;B组：年龄35~37岁（B1亚组：bFSH/bLH≥2,n=51;B2亚组：bFSH/bLH〈2,n=92）;C组：年龄〉37~40岁（C1亚组：bFSH/bLH≥2,n=28;C2亚组：bFSH/bLH〈2,n=46）;D组：年龄〉40岁（D1亚组：bFSH/bLH≥2,n=39;D2亚组：bFSH/bLH〈2,n=53）。比较各亚组的临床结局。结果 A、B组中,bFSH/bLH≥2组与bFSH/bLH〈2组间临床妊娠率、流产率均无显著性差异（P〉0.05）,但bFSH/bLH≥2组的获卵数及优胚率均显著低于bFSH/bLH〈2组,且促性腺激素（Gn）用量显著增加（P〈0.05）;C、D组中,bFSH/bLH≥2组临床妊娠率显著低于bFSH/bLH〈2组（P〈0.05）,但两组间窦卵泡数（AFC）、Gn用量、流产率均无显著性差异（P〉0.05）。结论在不孕不育女性患者中,对年龄≤37岁患者,血清bFSH/bLH比值可预测卵巢储备功能并指导Gn用量;对年龄〉37岁的患者,血清bFSH/bLH比值可预测IVF临床结局。Objective： To evaluate the predictive value of the ratio of basal FSH/LH on the outcome of IVF-ET in infertile women with normal FSH level. Methods： The data of 1 301 IVF/ICSI cycles in our center from Jan. 2011 to Dec. 2013 were analyzed retrospectively. According to the female＇s age, 1 301 cycles were divided into four groups：group A（under 35 years） ,group ]3（35-37 years） ,group C（38-40 years）and group D（above 40 years）. Then the four groups were subgrouped into eight groups： group A1 （300 cycles）, group A2 （692 cycles）, group B1 （51 cycles）, group B2 （92 cycles）, group C1 （28 cycles）, group C2 （46 cycles）, group D1 （39 cycles） and group D2 （53 cycles）respectively according to the ratio of bFSH/bLH≥2 or〈2. The clinical outcomes were compared among the groups. Results： There were no significant differences in clinical pregnancy rate and abortion rate between group A1 and group A2,group B1 and group B2（P〈0. 05）,but the oocytes retrieved,high-quality embryo rate in group A1 and B1 were significantly lower than those in group A2 and B2 respectively（P〈0.05）. Meanwhile the total dosage of gonadotropin administrated in controlled ovarian hyperstimulation（COH） were significantly increased in group A1 and B1 （P〈0. 05）. It was found that the clinical pregnancy rate in group D1 was significantly lower than that in group D2（P〈0.05）, but there were no significant differences in the antra follicle count,the oocytes retrieved,abortion rate between the two groups（P〉0. 05）. Conclusions. Basal FSH/LH ratio is a valuable predictor for ovarian reserve. It can be used for guiding gonadotropin administration in COH in the patients equal or less than 37 years old, and it can predict the pregnant outcome of IVF for the patients more than 37 years old.

关 键 词：基础FSH/LH比值 体外受精 妊娠结局 

分 类 号：R[医药卫生]