男性性激素与抗米勒管激素水平对体外受精-胚胎移植胚胎发育的影响  

Effects of male sex hormone and anti-Müllerian hormone level on the development of in vitro fertilization and embryo transfer embryos

作　　者：石绒 寇卉 马勤利 马琳枝 张洲 SHI Rong;KOU Hui;MA Qinli;MA Linzhi;ZHANG Zhou(Reproductive Center,Northwest Women and Children's Hospital,Xi'an 710004,Shaanxi,China)

机构地区：[1]西北妇女儿童医院生殖中心,西安710004

出　　处：《中国性科学》2024年第3期32-36,共5页Chinese Journal of Human Sexuality

摘　　要：目的探讨男性性激素与抗米勒管激素(AMH)水平对体外受精-胚胎移植(IVF-ET)胚胎发育的影响。方法回顾性分析2015年5月至2021年8月于西北妇女儿童医院接受体外受精(IVF)/卵胞质内单精子注射(ICSI)助孕的189例男性患者的临床资料,根据受精卵受精72h后是否有优质胚胎将其分为优质胚胎组和无优胚胎组。对比两组临床资料,通过LASSO和Logistic回归模型探讨影响优质胚胎形成的相关因素,采用受试者工作特征(ROC)曲线评价及性激素水平对胚胎发育情况的预测价值,构建列线图模型并进行评价。结果无优胚胎组的睾酮(T)、雌二醇(E_(2))、AMH、精子密度、精子活动率、精子速度试验结果、生育力指数、活动力指数低于优质胚胎组(P<0.05)。多因素分析结果显示,E_(2)、T、AMH水平及精子速度试验结果、生育力指数均为患者胚胎发育的独立影响因素(P<0.05)。与E_(2)、T及AMH单独预测相比,三者联合的预测效能明显较高。构建的列线图模型具有较高的区分度、准确性和临床适用性。结论血清E_(2)、T、AMH水平异常变化与男性不育症患者无优胚胎形成密切相关,三者联合对IVF-ET胚胎发育具有较高的预测价值,可作为临床筛选高危人群的敏感指标。Objective To investigate the effects of male sex hormone and anti-Müllerian hormone(AMH)levels on the development of in vitro fertilization-embryo transfer(IVF-ET)embryos.Methods The clinical data of 189 male patients who received IVF/intracytoplasmic sperm injection(ICSI)assisted pregnancy in Northwest Women and Children's Hospital from May 2015 to August 2021 were retrospectively analyzed.According to whether there were high-quality embryos in the fertilized eggs after 72 hours of fertilization,they were divided into high-quality embryos group and non-high-quality embryos group.The clinical data of the two groups were compared.The relevant factors affecting the formation of high-quality embryos were investigated through LASSO and Logistic regression models.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of sex hormone and AMH levels on embryonic development.Nomograph model was constructed and evaluated.Results Testosterone(T)level,estradiol(E_(2))level,sperm density,activity rate,sperm speed test index,fertility index and activity index of the non-high-quality embryo group were lower than those of the high-quality group(P<0.05).The results of multivariable analysis showed that E_(2) level,T level,AMH level,sperm speed test index and fertility index were all independent influencing factors of the patient's embryonic development(P<0.05).Compared with the single prediction of E_(2),T and AMH,the combined prediction efficiency of the three factors is significantly higher.The nomogram prediction model had high discrimination,accuracy and clinical applicability.Conclusions The abnormal changes of serum E_(2) level,T level and AMH level are closely related to the formation of non-high-quality embryos in male infertility patients.The combination of the three has high predictive value for the development of IVF-ET embryos,and can be used as a sensitive indicator for clinical screening of high-risk population.

关 键 词：抗米勒管激素 性激素 体外受精 胚胎移植 胚胎发育 

分 类 号：R697[医药卫生—泌尿科学]