性激素结合球蛋白对多囊卵巢综合征患者行体外受精-胚胎移植助孕结局的影响  

Exploring the influence of SHBG on the outcome in patients with PCOS undergoing IVF-ET

作　　者：何均 熊万宇 胡玥玥[3] HE Jun;XIONG Wanyu;HU Yueyue(Reproductive Medicine Center,Shiyan Taihe′s Hospital(Taihe′s Hospital Affiliated to Hubei Medical University),Shiyan442000,Hubei,China;Department of Critical Care Medicine,Shiyan Taihe′s Hospital(Taihe′s Hospital Affiliated to Hubei Medical University),Shiyan442000,Hubei,China;Reproductive Medicine Center,Shiyan People′s Hospital,Shiyan442000,Hubei,China)

机构地区：[1]十堰市太和医院(湖北医药学院附属太和医院)生殖医学中心,湖北十堰442000 [2]十堰市太和医院(湖北医药学院附属太和医院)重症医学科,湖北十堰442000 [3]十堰市人民医院生殖医学中心,湖北十堰442000

出　　处：《中国性科学》2022年第6期70-74,共5页Chinese Journal of Human Sexuality

摘　　要：目的研究性激素结合球蛋白(SHBG)对多囊卵巢综合征(PCOS)患者行体外受精-胚胎移植(IVF-ET)助孕结局的影响。方法收集2015年1月至2019年4月于十堰市人民医院生殖医学中心首次行IVF-ET助孕治疗的674例PCOS患者的临床资料作为研究对象。根据血清SHBG水平按四分位数分为四组:A组(≤46.25nmol/L),B组(46.26~80.34nmol/L),C组(80.35~109.00nmol/L),D组(>109.00nmol/L)。比较四组的基线资料、促排卵情况及妊娠结局,采用相关性及回归性分析影响助孕结局的危险因素。结果四组中C组患者成熟卵子和优质胚胎数最多,胚胎着床率、临床妊娠率及活产率最高,差异具有统计学意义(P<0.05);游离睾酮指数(FAI)与优质胚胎数及临床妊娠呈负相关(r=-0.115、-0.113,P<0.05),血清SHBG水平与优质胚胎数及临床妊娠呈正相关(r=0.137、0.128,P=0.001);Logistic回归性分析显示,血清SHBG水平影响优质胚胎数(B=0.003,P<0.05),但不是影响临床妊娠的独立危险因素(OR=1.002,P=0.307)。结论血清SHBG水平影响PCOS患者行IVF-ET助孕的优质胚胎数,将血清SHBG水平控制在80.35~109.00nmol/L,有利于PCOS患者行IVF-ET获得最佳的助孕结局。Objective To explore the influence of sex hormone-binding globulin(SHBG)on the outcome in patients with polycystic ovary syndrome(PCOS)undergoing in vitro fertilization and embryo transfer(IVF-ET).Methods Clinical data of 674 PCOS patients treated with IVF-ET for the first time in Reproductive Medicine Center of Shiyan People′s Hospital from January 2015 to April 2019 were collected as the research object.Subjects were divided into four quartile groups according to serum SHBG levels:group A(≤46.25 nmol/L),group B(46.26-80.34 nmol/L),group C(80.35-109.00 nmol/L),and group D(>109.00 nmol/L).The baseline data,ovulation induction and pregnancy outcome of the four groups were compared.Relation and regression analysis were used to explore the related factors affecting assisted outcome.Results The group C had the highest number of mature oocytes and high quality embryos,and the implantation rate,clinical pregnancy rate and live birth rate also were the highest(P<0.05);free testosterone index(FAI)was negatively correlated with the number of high quality embryos and clinical pregnancy(r=-0.115,-0.113,P<0.05),serum SHBG level was positively correlated with the number of high quality embryos and clinical pregnancy(r=0.137,0.128,P=0.001);Logistic regression analysis shows that serum SHBG level affected the number of high quality embryos(B=0.003,P<0.05),but not an independent risk factor for clinical pregnancy(OR=1.002,P=0.307).Conclusions Serum SHBG level can influence the number of high quality embryos;if the level of serum SHBG was controlled within 80.35-109.00 nmol/L,the best assisted outcome could be obtained in PCOS patients undergoing IVF-ET.

关 键 词：性激素结合球蛋白 多囊卵巢综合征 体外受精-胚胎移植 助孕结局 

分 类 号：R711[医药卫生—妇产科学]