摘要
Objective: We dynamically measured serum inhibin B and estradiol in the early stage of hormonal stimulation to predict the ovarian response in in vitro fertilization (IVF) treatment. Methods: A total of 57 patients (〈40 years of age) who underwent the first cycle of long protocol IVF or introcytoplasmic sperm injection (ICSI) treatment were included. Serum inhibin B, estradiol, follicle stimulating hormone (FSH) and luteinizing hormone (LH) levels were measured four times: (1) on Day 3 of the menstrual cycle (basal); (2) on the day before the first administration ofgonadotrophin (Gn) (Day 0); (3) on Day 1 of Gn therapy; and (4) on Day 5 of Gn therapy. Comparisons of these measurements with ovarian responses and pregnancy outcomes were made and analyzed statistically. Results: (1) On Day 1 and Day 5 of recombinant FSH (rFSH) stimulation, ovarian response, i.e., numbers of follicles, oocytes, fertilized oocytes, and embryos, had a positive correlation (rs=0.46-0.61, P 0.000) with raised inhibin B and estradiol concentrations, but a negative correlation (rs=-0.67--0.38, P=0.000 or P〈0.01) with total rFSH dose and total days ofrFSH stimulation. (2) No significant variation (P〉0.05) between the pregnant and non-pregnant groups on the basis of mean age or on all hormone concentrations at four times of the IVF cycle was observed. However, all the seven patients aged 〉35 years did not reach pregnancy. Conclusions: (1) Serum inhibin B and estradiol concentrations obtained shortly after Gn therapy may offer an accurate and early prediction of ovarian response; (2) Low levels of serum inhibin B and estradiol obtained shortly after Gn stimulation indicate the need for a longer period of Gn treatment and a higher daily dosage; (3) No obvious pregnancy difference among patients of age 〈35 years was found; however, IVF pregnancy outcome is significantly lower in women of age 〉35 years.
客观我们动态地在神经质的刺激的早阶段测量了浆液 inhibin B 和雌脂二醇预言卵巢的反应在在 vitro 授精(IVF ) 治疗。经历了第一的 57 个病人(<40 岁) 全部的方法 A 长协议 IVF 或介绍骑车细胞质的精子注射(ICSI ) 治疗被包括。浆液 inhibin B,雌脂二醇,滤泡刺激荷尔蒙(FSH ) 和 luteinizing (LH ) 层次被测量四次:(1 ) 在白天 3 月经周期上(基础) ;(2 ) 在在 gonadotrophin (Gn )( 白天 0 ) 的第一个政府前的日子;(3 ) 在白天 1 Gn 上治疗;并且(4 ) 在白天 5 Gn 上治疗。有卵巢的回答和怀孕结果的这些大小的比较统计上被做并且分析。白天 1 recombinant 和白天 5 FSH ( rFSH )刺激上的结果( 1 ),卵巢的反应,即,滤泡,卵母细胞,使肥沃的卵母细胞,和胚胎的数字,有积极关联( r <SUB > s </SUB>=0.46∼0.61, P=0.000 )与提起的 inhibin B 和雌脂二醇集中,但是否定关联( r <SUB > s </SUB>=−0.67∼−0.38, P=0.000 或 P<0.01 )与全部的 rFSH 剂量和 rFSH 刺激的全部的天。(2 ) 在怀孕、非怀孕的组之间的重要变化(P>0.05 ) 都不根据平均数变老或在在四点的所有荷尔蒙集中上, IVF 周期的次被观察。然而, >35 年的所有七个病人没到达怀孕。立即在 Gn 治疗以后获得的结论(1 ) 浆液 inhibin B 和雌脂二醇集中可以提供卵巢的反应的精确、早的预言;(2 ) 立即在 Gn 刺激以后获得的浆液 inhibin B 和雌脂二醇的底层为 Gn 治疗和更高每日的剂量的一个更长的时期显示需要;(3 ) 在年龄 <35 年的病人之中的明显的怀孕差别都没被发现;然而, IVF 怀孕结果在年龄 >35 年的女人是显著地更低的。