IVF-ET改良长方案超促排卵中体重指数与垂体降调节后血清FSH的相关性分析  

Correlation Analysis of the Body Mass Index and Serum FSH after Pituitary Down-regulation in Modified Long Protocol Controlled Ovarian Stimulation in IVF-ET

作　　者：江胜芳 刁红录 祝珊珊[1,2] 张昌军 JIANG Sheng-fang;DIAO Hong-lu;ZHU Shan-shan;ZHANG Chang-jun(Reproductive Medicine Center,Renmin Hospital;Hubei Clinical Research Center for Reproductive Medicine;Biomedical Engineering College;Biomedical Research Institute;Hubei Key Laboratory of Embry-onic Stem Cell Research,Hubei University of Medicine,Shiyan,Hubei 442000,China)

机构地区：[1]十堰市人民医院·湖北医药学院附属人民医院生殖医学中心 [2]湖北省生殖医学临床医学研究中心 [3]湖北医药学院生物医学工程学院 [4]湖北医药学院生物医药研究院 [5]湖北医药学院胚胎干细胞湖北省重点实验室,湖北十堰442000

出　　处：《湖北医药学院学报》2022年第1期42-46,64,共6页Journal of Hubei University of Medicine

基　　金：湖北省教育厅科学研究计划中青年人才项目(Q20202107)。

摘　　要：目的:通过分析体重指数(body mass index,BMI)与降调节第30天的血清促卵泡刺激素(follicle-stimulating hormone,FSH)的相关性,探讨BMI对垂体降调节深度的影响。方法:选取2017年10月-2019年7月在湖北医药学院附属人民医院生殖医学中心行卵泡期长效促性腺激素释放激素激动剂(gonadotropin release hormone agonist,GnRH-a)降调节长方案超促排卵体外受精-胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)病例1915例进行回顾性分析,对BMI与降调节后血清FSH值进行相关性分析并运用阈值效应分析找到BMI的折点。结果:BMI与降调节第30天血清FSH值正相关(调整后β=0.09,95%CI=0.07~0.1,P<0.01)。在基础FSH<7.5 mIU/mL组,当BMI大于26.17 kg/m^(2),BMI与降调节第30天血清FSH值负相关(β=-0.02,95%CI=-0.05~-0.02,P=0.3192)。由此确定BMI的折点是26.17 kg/m;(P<0.0001)。结论:当基础FSH<7.5 mIU/mL,BMI>26.17 kg/m;时,可以考虑减少降调节GnRH-a剂量以减轻对垂体的过度抑制,从而更加优化控制性超促排卵(controlled ovarian stimulation,COS)方案。Objective By analyzing the correlation between body mass index(BMI)and serum follicle stimulating hormone(FSH)on the 30 th day of down regulation,to explore the effect of BMI on the depth of pituitary down regulation.Methods From October 2017 to July 2019,1915 cases of in vitro fertilization and embryo transfer(IVF-ET)with long-term GnRH-a downregulation program in follicular phase in the reproductive medicine center of the Renmin Hospital affiliated to Hubei University of Medicine were analyzed retrospectively.Correlation analysis was used to analyze the correlation between BMI and serum FSH after downregulation,and threshold effect analysis was used to find the break point of BMI.Results BMI was positively correlated with serum FSH on the 30 th day of down-regulation(adjustedβ=0.09,95%CI=0.07 to 0.1,P<0.01).In the basal FSH<7.5 mIU/mL group,when BMI was higher than 26.17 kg/m;,BMI was negatively correlated with serum FSH on the 30 th day of downregulation(β=-0.02,95%CI=-0.05 to-0.02,P=0.3192).The breaking point of BMI was thus determined to be 26.17 kg/m;(P<0.001).Conclusion When the basal FSH is less than 7.5 mIU/mL and BMI is greater than 26.17 kg/m^(2),it can be considered to reduce GnRH-a dose to alleviate the excessive suppression of pituitary gland,so as to optimize the controlled ovarian stimulation(COS)program.

关 键 词：体重指数 垂体降调节 控制性促排卵 卵泡刺激素 相关性分析 

分 类 号：R714.8[医药卫生—妇产科学]