血清Δ抑制素B水平与体外受精/卵胞浆内单精子注射周期卵巢反应的关系  

The relationship between serum delta inhibin B levels and ovarian response in IVF/ICSI cycles.

作　　者：丁雪梅 马聪聪 徐慧玉 陈立雪[2] 李蓉[2] DING Xue-mei;MA Cong-cong;XU Hui-yu;CHEN Li-xue;LI Rong(Qujing First People's Hospital,Qujing 655000,China;不详)

机构地区：[1]曲靖市第一人民医院,云南曲靖655000 [2]北京大学第三医院妇产科生殖医学中心,北京100191

出　　处：《中国实用妇科与产科杂志》2023年第3期359-364,共6页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：北京市科技计划项目(Z191100006619076)。

摘　　要：目的探讨卵巢储备功能正常不孕女性血清Δ抑制素B(Δinhibin B,ΔINHB)水平与卵巢刺激后获卵数的关系,以及预测卵巢低反应和高反应的临界值。方法通过回顾性队列研究,纳入2021年12月至2022年3月在北京大学第三医院妇产科生殖医学中心633例行体外受精/卵胞浆内单精子注射(IVF/ICSI)拮抗剂方案卵巢功能正常的不孕女性,用重组人卵泡刺激素(r-HFSH)或重组卵泡刺激素(r-FSH)+重组黄体生成素(rLH)进行卵巢刺激,在刺激的前5d接受固定剂量的rFSH,使用促性腺激素(Gn)的D1和D5检测血清INHB,两者之差为ΔINHB。主要结局变量是不同时间点INHB与获得卵母细胞数量之间的相关性,以及预测卵巢低反应和高反应的临界值。结果血清ΔINHB浓度与获卵数呈正相关(Spearman相关系数r=0.587,P<0.001)。预测卵巢低反应和正常反应时,低反应组ΔINHB的临界值是295.5ng/L,敏感度、特异度和约登指数分别是78.9%、75.2%和0.541;预测高反应和正常反应时ΔINHB的临界值是515.5ng/L,敏感度、特异度和约登指数分别是74.1%、75.7%和0.498。ΔINHB水平与Gn的用量呈负相关。结论血清ΔINHB浓度可作为预测辅助生殖技术治疗不孕女性卵巢反应的生物标志物,对指导Gn的用量具有参考价值。Objective To investigate the relationship between delta inhibin B(INHB)levels in serum and the number of retrieved oocytes after ovarian stimulation in infertile women with normal reserved function of ovarian,and to predict the cut-off values in the low and high ovarian response.Methods Total 633 infertile women with normal ovarian function who underwent in vitro fertilization/intrafollicular sperm injection(IVF/ICSI)antagonist program in the Reproductive Medicine Center of Gynecology and Obstetrics of Peking University Third Hospital were included from December 2021 to March 2022.Ovarian stimulation was performed with recombinant human FSH(r-HFSH)or r-FSH combined recombinant LH(rLH).Received a fixed dose of rFSH 5 days before stimulation,D1 and D5 of gonadotropin was used to detect the INHB in serum.The difference between D5 and D1 was INHB.The main outcome variables were the correlation between INHB and the number of oocytes obtained at different time points,and the critical value of INHB to predict low and high ovarian response.Results The concentration of INHB in serum was positively correlated with the number of 0ocytes retrieved(Spearman correlation coeficient r=0.587,P<0.001).In the low response group,the critical value of INHB was 295.5ng/L.The sensitivity,specificity and Jordan index were 78.9%,75.2%and 0.541 respectively when the low and normal response of ovarian was predicted.When the high and normal response of ovarian was predicted,the critical value of inhibin B was 515.5ng/L.The sensitivity,specificity and Yoden index were 74.1%,75.7%and 0.498 separately。The INHB level was negatively correlated with dosage of Gn.Conclusion The concentration of INHB in serum can be used as a biomarker to predict the ovarian response of infertile women treated with assisted reproductive technology,and has certain reference value for guiding the dosage of Gn.

关 键 词：血清Δ抑制素B 控制性卵巢刺激 卵巢反应 

分 类 号：R719.8[医药卫生—妇产科学]