摘要
目的探讨抗苗勒氏激素(AMH)、年龄、窦卵泡(AFC)、雌二醇(E2)和促卵泡刺激素(FSH)对体外受精-胚胎移植(IVF-ET)患者卵巢反应性的预测价值。方法随机选取2016年1至12月在广西壮族自治区卫生计生委生殖中心生殖科接受IVF-ET治疗的不孕患者160例,对其基础性激素及AMH水平进行测定,并对直径1~5mm AFC数计数;记录优质胚胎率、卵裂率、正常受精率、获卵数、促性腺激素(Gn)总量、体质指数及年龄。根据获卵数分为低反应组、正常组和高反应组。应用受试者工作特征曲线(ROC)对5项指标对卵巢反应性的预测价值进行分析;并用Logistic回归分析5项指标对妊娠结局及胚胎发育的预测价值。结果各组AMH、AFC和年龄差异均有统计学意义(F值分别为117.40、119.42、204.12,均P<0.05),低反应组FSH/LH与其余组比较差异有统计学意义(t值分别为45.03、48.12,均P<0.05),高反应组的bFSH与其余组比较差异有统计学意义(t值分别为59.14、64.41,均P<0.05)。获卵数与AFC及AMH呈正相关(r值分别为0.54、0.50,均P<0.01),获卵数与E2之间无显著相关性(r=0.86,P=0.17),而获卵数与FSH及年龄则负相关(r值分别为-0.30、-0.21,均P<0.01)。ROC曲线显示:FSH和年龄对卵巢低反应预测优于其他指标,曲线下面积AUC分别是0.66、0.75;与单独AMH预测比较,AMH联合年龄预测卵巢低反应较优,AUC为0.88。AFC和AMH联合预测高反应AUC是0.83。结论年龄、FSH、AFC、AMH均能预测卵巢反应性,而其中FSH和年龄的预测相对较优;AFC和AMH单独或联合预测高反应均优于其余指标,而对于低反应预测时用年龄和AMH联合预测较优。
objective To explore the predictive value of anti-mullerian hormone（AMH）,age,antral follicles（AFC）,estradiol（E2）and follicle stimulating hormone（FSH）on ovarian response in patients undergoing in vitro fertilization and embryo transfer（IVFET）.Methods Altogether 160 infertile patients receiving IVF-ET were randomly selected.Basic hormone and AMH levels were measured,and number of AFC with diameter of 1-5 mm was counted.High quality embryo rate,cleavage rate,normal fertilization rate,number of retrieved oocytes,total amount of gonadotropin（Gn）,body mass index and age were recorded.Patients were divided into low response group,normal group and high response group according to number of retrieved oocytes.Predictive value of the five indexes on ovarian response was analyzed by using subject characteristic ROC.And predictive value of the five indexes on pregnancy outcomes and embryonic development was analyzed by logistic regression analysis.Results Differences in AMH,AFC and age among three groups were statistically significant（Fvalue was 117.40,119.42 and 204.12 respectively,all P〈0.05）.Difference in FSH/LH between low response group and the other groups was statistically significant（t value was 45.03 and 48.12 respectively,both P〈0.05）.There was significant difference in bFSH between high response group and the other groups（t value was 59.14 and 64.41 respectively,both P〈0.05）.Number of retrieved oocytes was positively correlated with AFC and AMH（r value was 0.54 and 0.40,respectively,both P〈0.01）.There was no obvious correlation between number of retrieved oocytes and E2（r=0.86,P=0.17）,but the number of retrieved oocytes was negatively correlated with FSH and age（r value was-0.30 and-0.21,respectively,both P〈0.01）.ROC curve showed that predictive value of FSH and age on ovarian poor response was better than that of other indexes,and the area under curve（AUC）was 0.66 and 0.75,respectively.Compared with AMH alone,AMH combined with age could better predict o
出处
《中国妇幼健康研究》
2017年第12期1688-1691,共4页
Chinese Journal of Woman and Child Health Research
关键词
抗苗勒氏激素
窦卵泡
体外受精-胚胎移植
雌二醇
anti-mullerian hormone （AMH）
antral follicles （AFC）
in vitro fertilization and embryo transfer （IVF ET）
estradiol （E2）
