基础卵泡刺激素对卵巢储备功能下降患者胚胎发育结局的预测价值  

Value of basal follicle-stimulating hormone in predicting the embryonic developmental outcome in patients with diminished ovarian reserve

作　　者：顾小铃 陈艳男 郁敏燕[1] 王霞[1] 王迪[1] GU Xiaoling;CHEN Yannan;YU Minyan(Reproductive Medicine Center,Affiliated Hospital,Nantong University,Nantong 226001,CHINA)

机构地区：[1]南通大学附属医院生殖医学中心,江苏226001

出　　处：《江苏医药》2021年第4期359-363,共5页Jiangsu Medical Journal

基　　金：南通市科技项目(JC2019017)。

摘　　要：目的探讨基础卵泡刺激素(bFSH)对卵巢储备功能下降(DOR)患者胚胎发育结局的预测价值。方法75例DOR患者首次进行高孕激素状态下促排卵(PPOS)方案,然后实施接受体外受精/卵胞浆内单精子显微注射。根据有无优质胚胎分为有优胚组(39例)和无优胚组(36例),比较两组临床资料,采用多因素logistic回归分析PPOS方案获得优质胚胎的影响因素,采用ROC曲线分析bFSH预测采用PPOS方案的DOR患者胚胎发育结局的价值。结果两组bFSH和抗苗勒氏管激素均有统计学差异(P<0.05)。多因素logistic回归分析显示,bFSH是DOR患者采用PPOS方案获得优质胚胎的独立影响因素(P<0.05)。bFSH预测采用PPOS方案的DOR患者胚胎发育结局的AUC为0.672[95%CI(0.547~0.797)];当bFSH最佳截断值为10.63 mIU/mL时,其预测DOR患者采用PPOS方案获得优质胚胎的灵敏度和特异度分别为61.1%和74.4%。bFSH≤10.63 mIU/mL患者获得优质胚胎比例高于bFSH>10.63 mIU/mL患者[67.44%(29/43)vs.31.25%(10/32)](P<0.05)。结论bFSH是DOR患者采用PPOS方案获得优质胚胎的独立影响因素,对DOR患者胚胎发育结局有一定的预测价值。Objective To investigate the value of basal follicle-stimulating hormone(bFSH)in predicting the embryonic developmental outcome in the patients with diminished ovarian reserve(DOR).Methods A total of 75 cases with DOR underwent progestin primed ovarian stimulation(PPOS)regimen for the first time and then accepted in vitro fertilization/intra-cytoplasmic sperm injection.The patients were divided into two groups.Group A(39 cases)had high-quality embryos and group B(45 cases)had no high-quality embryos.The clinical data were compared between the two groups.The influencing factors of obtaining high-quality embryos were analyzed by multivariate logistic regression.The value of bFSH in predicting the embryonic developmental outcome of DOR patients underwent PPOS regimen was analyzed by ROC curve.Results The levels of bFSH and anti-Müllerian hormone were significantly different between the two groups(P<0.05).Multivariate logistic regression analysis showed that bFSH was the independent influencing factor for DOR patients underwent PPOS regimen obtaining high-quality embryos(P<0.05).The AUC of bFSH in predicting the embryonic developmental outcome of DOR patients underwent PPOS regimen was 0.672[95%CI(0.547-0.797)].When the optimal cut-off value of bFSH was 10.63 mIU/mL,the sensitivity and specificity in predicting the high-quality embryos were 61.1%and 74.4%,respectively.The ratio of high-quality embryos in the patients with bFSH≤10.63 mIU/mL were higher than that in the patients with bFSH>10.63 mIU/mL[67.44%(29/43)vs.31.25%(10/32)](P<0.05).Conclusion bFSH is an independent influencing factor for DOR patients taking PPOS regimen and obtaining high-quality embryos.bFSH has a certain value in predicting the embryonic developmental outcome in the patients with DOR.

关 键 词：基础卵泡刺激素 卵巢储备功能下降 胚胎发育 

分 类 号：R711[医药卫生—妇产科学]