基础睾酮和AMH对卵巢低反应患者IVF-ET结局的预测  

Basal testosterone and AMH predict IVF-ET outcome in patients with low ovarian response

作　　者：雷玲玲[1] 杨洋[1] 王树玉[1] LEI Ling-ling;YANG Yang;WANG Shu-yu(Department of Reproductive Medicine,Beijing Obstetrics and Gynaecology Hospital,Capital Medical University,Beijing 100026)

机构地区：[1]首都医科大学附属北京妇产医院,北京100026

出　　处：《中国优生与遗传杂志》2018年第7期101-104,共4页Chinese Journal of Birth Health & Heredity

基　　金："首都医科大学附属北京妇产医院青年基金专项"资助课题(FCYYQN-201508);北京市医院管理局"青苗"计划专项经费(QML20151304)

摘　　要：目的探讨基础睾酮(bT)和抗苗勒管激素(AMH)水平对卵巢低反应(POR)患者行体外受精-胚胎移植(IVF-ET)妊娠结局的预测作用。方法采用回顾性分析的研究方法,分析2015年1月~2016年12月于我院生殖中心行IVF助孕的372个POR患者的临床资料,按照妊娠结局分为妊娠组和未妊娠组,探讨bT和AMH对卵巢功能和IVF妊娠结局的影响。结果与未妊娠组相比,妊娠组POR患者的AMH、bT、窦卵泡数(AFC)及获卵数显著升高,基础卵泡刺激素(b FSH)显著降低,差异均有统计学意义(P<0.05);Pearson相关性分析显示,体重指数(BMI)、AMH、AFC及获卵数与bT水平呈正相关;ROC曲线分析显示,bT水平与POR患者IVF妊娠结局存在相关性,曲线下面积(AUC)为0.726(95%CI 0.666~0.787,P<0.01),bT的最佳界值为30.62ng/dl,敏感度76.7%,特异度61.9%。而AMH水平与IVF妊娠率不存在显著相关性,AUC为0.571(95%CI 0.501-0.642,P>0.05),不具有诊断价值。结论 bT水平与卵巢功能呈正相关,且对POR患者IVF妊娠结局具有较好的预测价值,当POR患者bT水平高于30.62ng/dl时临床妊娠率较高。而血清AMH不能作为预测POR患者IVF妊娠结局的指标。Objective：To investigate the association of basal testosterone（bT）and anti-Mullerian hormone（AMH）level with the outcome of in vitro fertilization-embryo transfer（IVF-ET）in patients with poor ovarian response（POR）. Methods：The effects of bT and AMH level on the outcome of IVF were retrospectively analyzed involved 372 patients with POR patients undergoing IVF from January 2015 to December 2016. The patients were divided into two groups,include the pregnancy group and non-pregnancy group. Results：Compared with the non-pregnancy group,AMH,basal follicle stimulating hormone（b FSH）,bT,antral follicle count（AFC）,and the number of oocytes retrieved were significantly higher in the pregnancy group of POR patients（P〈0.05）,By Pearson correlation,body mass index（BMI）,AMH,AFC and the number of oocytes retrieved were positively correlated with bT. By using receiver operating characteristic（ROC）analysis,the bT level presented a positive association with pregnancy outcome in POR women,the area under of ROC is 0.726（95%CI 0.666-0.787,P〈0.01）,and the cut-off value of bT was 30.62 ng/dl. The sensitivity and specificity were 76.7% and 61.9% respectively. the AMH level can not present a association with pregnancy outcome in POR women,the area under of ROC is 0.571（95% CI 0.501~0.642,P〉0.05）,it does not have diagnostic value. Conclusion：In POR women,bT presented a positive association with ovarian reserve,and bT is a good predictive marker for the IVF outcome. The patients have a better pregnancy rate,when bT higher than 30.62 ng/dl. But AMH can not be used predict the outcome of IVF with POR patients.

关 键 词：基础睾酮 抗苗勒管激素(AMH) 卵巢低反应 体外受精-胚胎移植 

分 类 号：R321-33[医药卫生—人体解剖和组织胚胎学]