基础血清LH/FSH、25-羟维生素D联合窦卵泡计数在高龄不孕女性体外受精-胚胎移植妊娠结局中的预测价值  

Predictive value of basal serum LH/FSH and 25-hydroxy vitamin D combined with antral follicle count in pregnancy outcome of in vitro fertilization-embryo transfer in infertile women of advanced age

作　　者：查钱江 陈志云[1] 纪妍[1] 刘新[1] 刘晓艳[1] 陈晓林[1] ZHA Qianjiang;CHEN Zhiyun;JI Yan;LIU Xin;LIU Xiaoyan;CHEN Xiaolin(Center of Reproductive Medicine,People's Hospital of Huizhou Center,Huizhou,Guangdong,China,516000)

机构地区：[1]惠州市中心人民医院生殖医学中心,广东惠州516000

出　　处：《分子诊断与治疗杂志》2025年第3期536-539,共4页Journal of Molecular Diagnostics and Therapy

基　　金：惠州市科技计划项目(2022CZ010023)。

摘　　要：目的探究基础血清促黄体生成素/卵泡刺激素(LH/FSH)、25-羟维生素D(25-(OH)D)联合窦卵泡计数(AFC)对高龄不孕女性体外受精-胚胎移植(IVF-ET)妊娠结局的预测价值。方法纳入2021年1月至2023年12月在惠州市中心人民医院生殖医学中心接受IVF-ET助孕的高龄不孕女性356例,按妊娠结局分为妊娠组(159例)和无妊娠组(197例)。采用单因素和二元logistics回归分析影响高龄不孕女性IVF-ET妊娠结局的危险因素,并通过受试者工作特征曲线(ROC)分析基础血清LH/FSH、25-(OH)D联合AFC对高龄不孕女性IVF-ET妊娠结局的预测效果。结果两组的不孕年限、体质量指数(BMI)和促性腺激素(Gn)剂量相比较,差异无统计学意义(P>0.05)。妊娠组的年龄比无妊娠组的显著更低,抗苗勒管激素(AMH)、基础血清LH/FSH、25-(OH)D和AFC则显著更高,差异均具有统计学意义(P<0.05)。logistics回归分析结果显示,高龄不孕女性的年龄增长是IVF-ET无妊娠的危险因素,AMH、基础血清LH/FSH、25-(OH)D和AFC水平上升均为IVF-ET无妊娠的保护因素(P<0.05)。ROC结果显示,基础血清LH/FSH、25-(OH)D联合AFC预测高龄不孕女性IVF-ET妊娠结局的曲线下面积为0.880,敏感度为0.874,特异度为0.731。结论基础血清LH/FSH、25-(OH)D和AFC的水平异常与高龄不孕女性IVF-ET妊娠结局有关,三种指标联合对高龄不孕女性IVF-ET妊娠结局的预测有良好的应用价值。Objective To investigate the predictive value of basal serum luteinizing hormone/follicle stimulating hormone(LH/FSH),25-hydroxy vitamin D(25-(OH)D)combined with antral follicle count(AFC)on the pregnancy outcome of in-vitro fertilization-embryo transfer(IVF-ET)in elderly infertile women.Methods A total of 356 elderly infertile women who underwent IVF-ET assisted conception at the Reproductive Medicine Center of Huizhou Central People's Hospital from January 2021 to December 2023 were included.They were divided into the pregnancy group(159 cases)and the no-pregnancy group(197 cases)based on their pregnancy outcomes.Risk factors affecting IVF-ET pregnancy outcomes in elderly infertile women were analyzed using univariate and binary logistic regression.Additionally,the predictive effect of basal serum LH/FSH and 25-(OH)D combined with AFC on IVF-ET pregnancy outcomes in elderly infertile women was analyzed using receiver operating characteristic curve(ROC).Results The differences between the two groups were not statistically significant when comparing the years of infertility,body mass index(BMI),and gonadotropin(Gn)dose(P>0.05).However,age was significantly lower in the pregnant group,while anti-mullerian hormone(AMH),basal serum LH/FSH,25-(OH)D,and AFC were significantly higher in the pregnant group compared to the non-pregnant group.These differences were all statistically significant(P<0.05).Logistic regression analyses showed that increasing age was a risk factor for IVF-ET nulliparity in elderly women with infertility.Converely,increasing levels of AMH,basal serum LH/FSH,25-(OH)D,and AFC were identified as protective factors for IVF-ET nulliparity(P<0.05).The ROC results demonstraed that the area under the curve of basal serum LH/FSH,25-(OH)D combined with AFC for predicting IVF-ET pregnancy outcome in elderly infertile women was 0.880,with a sensitivity of 0.874 and specificity of 0.731.Conclusion Abnormal levels of basal serum LH/FSH,25-(OH)D,and AFC are associated with IVF-ET pregnancy outcomes in elderly

关 键 词：体外受精-胚胎移植 促黄体生成素/卵泡刺激素 25-羟维生素D 窦卵泡计数 高龄女性 

分 类 号：R71[医药卫生—妇产科学]