基础FSH/LH比值及晚卵泡期LH水平对体外受精-胚胎移植结局的影响

目的:探讨患者基础FSH/LH比值及控制性超促排卵(COH)时降调后hCG注射日血清LH水平对IVF-ET结局的影响及与COH各参数的关系。方法:回顾性分析首次进行IVF/ICSI-ET助孕、应用GnRH-a长方案降调节的不孕妇女,共427个周期。结果:ROC曲线显示FSH/LH比值与IVF-ET临床妊娠率无明显相关性;FSH/LH≥2与FSH/LH<2组间虽然临床妊娠率无差异,但FSH/LH≥2组Gn用量增加,获卵数少,优质胚胎数少,存在统计学差异(P<0.05)。hCG注射日血清LH≥0.65IU/L者妊娠率(55.8%)明显高于LH<0.65IU/L者(24.6%)。结论:基础FSH/LH比值增高能较早反映卵巢储备功能并指导超排方案及Gn用量;降调节后卵泡晚期(hCG注射日)的LH水平过低(<0.65IU/L),将会导致临床妊娠率下降。

Effect of the Basal FSH:LH Ratio and LH Level in Late Follicle Phase on IVF Outcome

Objective：To investigate the effects of the basal serum FSH：LH ratio and luteinizing hormone（LH） level in late follicle phase on IVF outcome.Methods：A retrospective analysis of 427 cycles using a long protocol with GnRH-a and rFSH was performed.Results：According to the ROC curve,the basal FSH：LH ratio had no significant effect on clinical pregnancy rate of IVF/ICSI treatment.In FSH/LH≥2 group,more gonadotropin was needed,less oocytes and good-quality embryo were obtained,when serum LH level ≥0.65 IU/L on the day of hCG injection,clinical pregnancy rate was significantly higher than that in LH〈0.65（55.8% vs 24.6%,P〈0.01）.Conclusion：Basal FSH：LH ratio is a better marker to predicate the ovarian reserve function and helpful for selection of the optimal controlled ovarian hyperstimulation（COH） protocol.Low LH concentrations（〈0.65 IU/L） during the late follicular phase might be detrimental to clinical pregnancy rate in IVF/ICSI treatment by long protocol.