基础睾酮水平与不同卵巢储备患者体外受精周期卵巢反应的关系

目的探讨基础睾酮(testosterone,T)水平与不同卵巢储备能力患者体外受精周期(in vitro fertilization,IVF)卵巢反应的相关性。方法对248例首次行IVF的患者行回顾性分析,先按基础日FSH/LH及FSH值大小分成卵巢储备能力正常组(A组164例)和卵巢储备能力低下组(B组84例)分别进行研究,取总体样本248例患者的T值均数为截点,将A、B组分别分为组1(T<0.5ng/ml)和组2(T≥0.5ng/ml),比较组1和组2间卵巢反应参数均值差异;用Pearson相关性分析分别分析A、B两组中T值与卵巢反应参数的相关性;运用多元回归寻找影响获卵数的独立因素;运用受试者工作(receiver operating curve,ROC)曲线分别评价各指标在A、B组患者中预测卵巢反应的价值。结果 (1)A组:①A1组卵巢反应参数低于A2组,差异有统计学意义。②基础T值与卵巢反应参数明显正相关(P<0.05)。③T值是影响获卵数的独立因素之一,且在该组中对获卵数影响最大(P<0.01)。④根据ROC曲线结果当T值为0.500ng/ml的时候,其诊断卵巢低反应的敏感度为86.5%特异度为76.2%。(2)B组中:①B1组部分卵巢反应参数高于B2组,差异有统计学意义。②基础T值与部分卵巢反应参数负相关(P<0.05)。③T值是影响获卵数的独立因素之一,但影响是负面的。④ROC曲线显示该组中基础窦卵泡数(AFC)较T值对卵巢反应具有更高的预测价值。结论在卵巢储备能力低下的组,血清基础睾酮值与体外受精周期卵巢反应参数正相关,对卵巢低反应具有较强的预测价值;卵巢储备能力尚好的组,血清基础睾酮值与部分卵巢反应参数负相关,不具备明显的预测卵巢反应的价值。

Correlation between basal serum T level and ovarian response in women with different ovarian reserve capacity during IVF -stimulated cycles

Objective： To explore the correlation between basal serum testosterone （T） level and ovarian response in women with different ovarian reserve capacity during IVF - stimulated cycles. Methods ： A total of 248 patients undergoing their first cycles of IVF treatment were retrospective analyzed. According to FSH/LH ratio and the basal FSH level, the 248 patients were allocated into group A and group B. The two groups were divided into groupl and group 2 separately with mean level of testosterone was made as a cut - off point. Ovarian response parameters were compared between groupl and group2; the correlation between testosterone and ovarian re- sponse parameters were analyzed using pearson analysis; multiple regression was used to find the independent factor affecting the num- ber of oocytes; The value of each indicates in prediction of ovarian response was assessed using receiver operating curve （ROC）. Result ： （1）In Group A ： （1）ovarian response was significantly higher in groupl than in group2 （2）basal T was positive correlated with ovarian response parameters（3）T level was one of the independent factor affecting the number of oocytes（4）A testosterone level of 0. 5ng/ml was shown to predict poor response with a sensitivity of 86. 5% and specificity of 76. 2%. （2）In Group B（1）basal T was negative correlated with ovarian response （2）the receiver operating curve showed that the antral follicle number had a better predictive value than testosterone of ovarian response. Conclusion： In women with diminished ovarian reserve basal T was a good predictor for the ovarian response; but not in those with normal ovarian reserve.