两种基础激素对体外受精-胚胎移植妊娠结局的影响

目的 探讨基础卵泡刺激素（FSH）、抑制素B（inhibinB）水平对体外受精-胚胎移植（IVF-ET）结局的预测价值。方法 随机选择180例接受IVF—ET治疗的不孕症病人，于月经第2天抽取空腹血检测FSH、inhibinB水平，并按不同FSH、inhibinB水平分组，比较各组卵巢反应性及IVF-ET结局。结果 随FSH升高，卵巢反应性呈递减趋势，而妊娠率在FSH〉10U／L才有显著性变化；随inhibinB升高，卵巢反应性呈递增趋势，当inhibin B≤50ng／L，妊娠率显著降低，差异均有显著意义（F=12．36、18．82，P〈0．01；χ^2=8．10～14．22，P〈0．05）。结论 FSH是评价卵巢储备功能的较好指标，但在临床上对妊娠结局的预测实用价值不大。inhibinB能够更好反映卵巢储备功能，且对IVF-ET结局预测优于FSH。

THE INFLUENCE OF BASAL LEVELS OF FSH AND INHIBIN B ON OVARIAN RESPONSE AND PREGNANCY OUTCOME

Objective To assess the predictive value of basal levels of serum FSH and inhibin B in vitro fertilization and embryo transplantation(IVF-ET). Methods Infertile women(n=180) received IVF-ET therapy were enrolled randomly in this study.Serum levels of FSH and inhibin B were measured on the second day of the menses.The differences in ovarian response and the pregnancy rate were compared with the different levels of serum FSH and inhibin B. Results With the increase of the serum FSH levels,the ovarian response exhibited a tendency to decreasing.When serum FSH level exceeded 10 U/L,the pregnancy rate decreased significantly(P<0.05).However,the ovarian response increased with the increase of the serum inhibin B levels.When the serum inhibin B level was below 50 ng/L,a poor IVF-ET outcome was predicted(P<0.05). Conclusion The FSH level is a good index in terms of evaluation of the ovarian reserve,but,clinically,there is little value in predicting the outcome of IVF-ET pregnancy.Inhibin B is much better than FSH to reflect the ovarian reserve and predict the pregnacy.