年龄、基础卵泡刺激素及窦卵泡数预测卵巢反应性的价值

目的 探讨年龄、基础卵泡刺激素（bFSH）及基础窦卵泡数（antral follicle count,AFC）预测卵巢反应性的价值.方法 回顾性分析本中心2003年1月至2009年7月5,453例应用长方案行体外受精/卵胞浆内单精子注射-胚胎移植（IVF/ICSI-ET）患者的临床资料.结果 （1）年龄、bFSH 与外源性促性腺激素（Gn）用量呈显著正相关,AFC与Gn用量呈显著负相关（r分别为0.364、0.325和-0.450）.年龄、bFSH 与成熟卵泡数呈显著负相关,AFC与成熟卵泡数呈显著正相关 （r分别为-0.285、-0.299和0.516）.AFC与Gn用量及成熟卵泡的相关性均最密切.（2）年龄、bFSH 与AFC预测卵巢低反应的ROC曲线下面积AUC I、AUC2、AUC3分别为0.68、0.69、0.85,均显著〉参考下面积（P均〈0.05）;AUC3均大于AUC1及AUC2,差异有统计学意义（Z13=9.42,Z23=7.28,P均〈0.05）,AUCI及AUC2比较无显著差异（Z12=0.46,P〉0.05）.结论 年龄、bFSH、AFC均可以预测卵巢反应性,且AFC的预测价值优于bFSH及年龄.

Value of age, basal follicle-stimulating hormone and antral follicle count in predicting ovarian response in women undergoing in vitro fertilization/intracytoplasmic sperm injection and embryo transfer

Objective： To investigate the value of age, basal follicle-stimulating hormone （bFSH） and antral follicle count （AFC） in the prediction of ovarian response in women undergoing in vitro fertilization/intracytoplasmic sperm injection and embryo transfer （IVF/ICSI ET） Methods： The clinical data of 5,453 long protocol IVF/ICSI-ET cycles in this hospital from January 2003 to July 2009 were analyzed retrospectively. Results： （1） The age and bFSH levels were positively correlated and AFC inversely correlated with gonadotropin ampoules （r=0. 364, 0. 325, and -0. 450, P〈0.05, respectively）. The age and bFSH levels were inversely related and AFC positively related to the number of mature follicles （r =-0. 285, -0. 299 and 0. 516, P〈0.05, respectively）. Among these parameters, AFC was most correlated with ovarian response; （2） The areas under ROC curve （AUC） of age, bFSH and AFC were 0.68 （AUCl） , 0.69 （AUC2） and 0.85 （AUC3）, respectively, and all were larger than those under the diagnosis reference line for predicting the poor response （P〈0.05）. AUC3 was significantly larger than AUC1 and AUC2 （Z13 = 9.42 and Z23=7.28, P〈0.05, respectively）, and there was no significant difference between AUC1 and AUC2 （Z12 =0.46, P〉0.05）. Conclusions： Age, bFSH and AFC are all valuable in the prediction of ovarian response, and AFC is the best predictor of all three.