应用ROC曲线评估年龄、窦卵泡数及基础卵泡刺激素预测卵巢储备功能的价值

目的:探讨年龄、窦卵泡数(antral follicle count,AFC)、基础卵泡刺激素(bF-SH)预测卵巢储备功能的价值。方法:应用受试者工作特征曲线(ROC),回顾性分析本中心2003年1月～2009年12月6387例应用长方案行体外受精/卵细胞内单精子注射-胚胎移植(IVF/ICSI-ET)患者的临床资料。结果:(1)年龄、AFC与bFSH预测卵巢低反应的ROC曲线下面积AUCl、AUC2、AUC3分别为0.69、0.86、0.70,均大于机会参考线下面积(P<0.05),AUC2大于AUCl及AUC3,差异有统计学意义(Z12=9.43,Z23=8.21,P均<0.05),AUCl及AUC3差异无统计意义(Z13=0.35,P>0.05)。(2)年龄、AFC与bFSH预测临床妊娠的ROC曲线下面积AUC4、AUC5、AUC6分别为0.57、0.55、0.53,均大于机会参考线下面积(P<0.05),AUC4大于AUC5及AUC6,差异有统计学意义(Z45=2.21,Z46=3.98,P均<0.05),AUC5与AUC6差异无统计意义(Z56=1.77,P>0.05)。(3)AUCl值、AUC2值、AUC3均分别显著大于AUC4、AUC5、AUC6(Z14=7.18,Z25=24.75,Z36=9.31,P均<0.05)。结论:年龄、AFC及bFSH均能预测卵巢的储备功能。对于卵巢低反应的预测价值,AFC高于年龄及bFSH。对于临床妊娠的预测价值,年龄高于AFC及bFSH。且年龄、AFC及bFSH对卵巢低反应的预测价值均高于对临床妊娠的预测价值。

Evaluating the predictive value of age, AFC and bFSH on ovarian reserve function by receiver operating characteristic analysis

Objective:To evaluate the predictive value of age,AFC and bFSH on ovarian reserve function in women undergoing in vitro fertilization and embryo transfer.Methods:6387 long protocol IVF/ICSI-ET cycles from Jan.2003 to Dec.2009 were analyzed retrospectively by ROC curve.Results:(1)The areas under ROC curve(AUC)of age,AFC and bFSH for predicting the poor response rate were 0.69(AUCl),0.86(AUC2),and 0.70(AUC3)respectively,which were all larger than the areas under the diagnosis reference line(P<0.05).AUC2 was s...