不同年龄段患者基础FSH/LH比值对IVF/ICSI-ET临床结局的预测价值

目的 探讨患者基础卵泡刺激素/基础黄体生成素(FSH/LH)比值对体外授精/卵胞浆内单精子注射-胚胎移植(IVF/ICSI-ET)过程中获卵总数、优质胚胎的获得和临床结局的预测价值.方法 回顾性分析因单纯输卵管因素或男方因素行IVF/ICSI-ET(长方案)助孕并行新鲜胚胎移植的1629例患者的病历资料,根据患者的年龄和FSH/LH比值分为A、B、C共3组,A组:年龄<30岁(A1亚组:FSH/LH<2,n=452;A2亚组:FSH/LH≥2,n=144);B组:年龄30~35岁(B1亚组:FSH/LH<2,n=551;B2亚组:FSH/LH≥2,n=240);C组:年龄36~40岁(C1亚组:FSH/LH<2,n=148;C2亚组:FSH/LH≥2,n=94).比较各年龄段亚组患者控制性超促排卵(COH)结果以及IVF结局.结果 A组中,A1亚组的促性腺激素(Gn)用量明显低于A2亚组,差异有统计学意义(P<0.05);A1亚组的获卵数和优质胚胎数明显高于A2亚组,差异有统计学意义(P<0.05).B组中,B1亚组的获卵数明显低于B2亚组,差异有统计学意义(P<0.05).C组中,C1亚组和C2亚组在获卵数和优质胚胎数之间差异也具有统计学意义(P<0.05).A、B、C 3组各亚组在患者的妊娠率、流产率差异均无统计学意义.结论 基础FSH/LH比值可以作为判断不同年龄段患者COH结果的重要指标,但却不能单独预测IVF/ICSI-ET临床结局.

Value of basal FSH/LH ratio on the pregnancy outcome of IVF/ICSI-ET

Objective To explore the predictive value of the ratio of baseline follicle stimulating hormone versus lu-teinizing hormone ( FSH/LH) in the number of oocytes retrieved, the high-quality of embryos and the clinical out-come in the process of IVF/ICSI-ET. Methods Medical records of 1629 patients undergoing long GnRH-a proto-col were analyzed. The patients was divided into three groups according to the female' s age: group A( under 30 years) , group B(30~35 years) and group C(36~40 years) . Then each group was subdivided into two subgroups based on the FSH/LH ratio:group A1 ( FSH/LH<2 , n=452 ) , group A2 ( FSH/LH≥2 , n =144 ) , group B1 ( FSH/LH<2 , n=551 ) , group B2 ( FSH/LH≥2 , n=240 ) , group C1 ( FSH/LH<2 , n=148 ) and group C2 ( FSH/LH≥2 , n=94 ) . The results of the COH and the outcome of IVF were compared between subgroups of all age groups. Results The dosage of Gn used in group A1 was significantly lower than that in A2 (P<0. 05), and the number of oocytes retrieved and the high-quality of embryos in group A1 and C1 were significantly higher than those in group A2 and C2 (all P<0. 05). Meanwhile, there was significant difference beween group B1 and B2 in the number of oocytes retrieved ( P<0. 05 ) , but there were no significant differences between group A1 and A2 , B1 and B2, C1 and C2 in clinical pregnancy rate and abortion rate. Conclusion The ratio of FSH/LH might be selected as one of the important predictors of COH, but it can' t predict the clinical outcome of IVF/ICSI-ET alone.