基础卵泡刺激素/黄体生成素值预测不同年龄患者体外受精/卵胞浆内单精子注射助孕结局的价值  

The value of basal follicle stimulating hormone/luteinizing hormone in predicting the outcomes of in-vitro fertilization/intracytoplasmic sperm injection in different age patients

作　　者：王雪梅 王芳 鲜红 WANG Xue - mei;WANG Fang;XIAN Hong(Reproductive Institute, Chengdu Women and Children＇s central Hospital, Chengdu Sichuan 610019, P. R. China)

机构地区：[1]成都市妇女儿童中心医院生殖研究所,四川成都610019

出　　处：《中国计划生育和妇产科》2017年第11期31-33,42,共4页Chinese Journal of Family Planning & Gynecotokology

摘　　要：目的探讨基础卵泡刺激素(follicle stimulating hormone,b FSH)和黄体生成素(luteinizing hormone,LH)比值对不同年龄段的不孕患者行体外受精(in-vitro fertilization,IVF)/卵胞浆内单精子注射(intracytoplasmic sperm injection,ICSI)助孕结局的预测价值。方法回顾性分析2011年在成都市妇女儿童中心医院生殖中心因输卵管阻塞、男方少弱精子、不明原因不育等行IVF/ICSI-胚胎移植年龄≤40岁的超排患者381例(381周期)。按年龄分A、B、C 3组,A组:年龄≤30岁;B组:30<年龄<35岁;C组:年龄≥35岁。各组中再根据b FSH/LH分为两组,A 1组:FSH/LH<3,A 2组:FSH/LH≥3;B 1组:FSH/LH<3,B 2组:FSH/LH≥3;C 1组:FSH/LH<3,C 2组:FSH/LH≥3。比较各组患者在促性腺激素(gonadotropin,Gn)用量、获卵数、2 PN数、卵裂率、优质胚胎率、临床妊娠率的差异。结果 A、B、C组随着年龄增长,Gn用量逐渐增加,差异有统计学意义(P<0.05);A组与B、C组优胚数比较,差异有统计学意义(P<0.05);C组获卵数、2 PN数及卵裂数与A、B组比较,差异有统计学意义(P<0.05)。3组的妊娠率随年龄增长而降低,分别为:44.2%、43.0%、36.4%,但差异无统计学意义(P>0.05)。在B组中,随着b FSH/LH增加,获卵数、2 PN数、卵裂数降低,差异有统计学意义(P<0.05)。在C组中,随着b FSH/LH增加,2 PN数、卵裂数、优胚数降低,差异有统计学意义(P<0.05)。结论年龄结合b FSH/LH值可较好地评估卵巢储备功能及预测超促排卵中卵巢的反应性,对IVF临床治疗方案及Gn用药有指导意义,但仍需结合更多指标进行卵巢储备功能的评估。Objective To investigate the predictive significance of basal follicle stimulating hormone （FSH）/luteinizing hormone （LH） ratio on the outcomes of in -vitro fertilization（ IVF）/intracytoplasmic sperm injection（ICSI） in infertile couples of different age. Methods A total of 381 stimulating IVF/ICSI cycles with patients average age under 40 in 2011 in Chengdu Women and Children＇s Central Hospital were studied retrospectively. The infertile pathogeny included male factor, fallopian tube factor or unexplained infertility. All patients and cycles were divided into following three groups ： group A （ age 〈 30）, group B （ 30 〈 age 〈 35 ） and group C （age I〉 35 ）. According to FSH/LH value, the three groups were each divided into two groups：group A1 （age ≤30, FSH/LH 〈 3 ）, group A2 （ age ≤ 30, FSH/LH i〉 3 ） ; group B1 （ 30 〈 age 〈 35, FSH/LH 〈 3 ）, group B2 （ 30 〈 age 〈 35, FSH/LH ≥ 3 ） ; group C 1 （ age ≥ 35, FSH/LH 〈 3 ）, groupC2 （ age 〉/35, FSH/LH ≥ 3 ）. Total dosage of gonadotrophins （ Gn ）, number of oocytes retrieved, top quality embryo rate,clinical pregnancy rate and 2 PN rate were analyzed. Results With age increased, Gn dosage of the three groups gradually increased, the differences were statistically significant（P 〈0. 05 ）. There were significant differences between group A and group B or C about high quality embryo rate （P 〈 O. 05 ）. The number of ooeytes retrleved,2 PN and cleavage number of group C were less than group A and B（P 〈0. 05）. The clinieal pregnancy rate of the three groups decreased with age （44.2%, 43.0%, 36.4% ）, but there were no significant differences. In group B, the number of oocytes,2PN and cleavage decreased with the increase of bFSH / LH, the differences were statistically significant（ P 〈 0. 05）. In group C, the number of 2PN, cleavage and top quality embryo decreased with the increase of bFSH,/LH, the differences were statistically significant（P 〈0. 05 ）.

关 键 词：基础卵泡刺激素/黄体生成素值 年龄 体外受精 卵胞浆内单精子注射 卵巢储备功能 

分 类 号：R715.2[医药卫生—妇产科学]