降调节后血清E_2和FSH/LH比值预测卵巢反应性及助孕结局的价值

目的探讨在IVF/ICSI-ET过程中,对垂体进行降调节后,血清雌激素（E2）、卵泡刺激素（FSH）/黄体生成素（LH）比值在控制性超排卵（COH）中预测卵巢反应性的价值。方法回顾分析103个IVF//ICSI-ET周期,均采用黄体中期长方案降调节,按降调后月经第2日血清雌激素水平分为3组,分别为A组：E2≤20 pg.mL-1;B组：20 pg.mL-1〈E2≤30 pg.mL-1;C组：E2〉30pg.mL-1。按FSH/LH比值分4组,分别为1组：FSH/LH≤1;2组：1〈FSH/LH≤2;3组：2〈FSH/LH≤3;4组：FSH/LH〉3,比较各组间Gn天数、Gn总剂量、获卵数、成熟卵子数及临床妊娠率的情况。结果 （1）E2不同的3组间Gn总剂量、获卵数、成熟卵泡数及临床妊娠率等比较均无统计学意义（P〉0.05）,但是在Gn天数和Gn总剂量上B组均低于A组和C组,且B组的临床妊娠率最高。（2）FSH/LH比值越大组获卵数、成熟卵泡数越低。且2〈FSH/LH≤3组妊娠率最高,有统计学意义（P〈0.05）。结论 （1）降调节后月经第2日血清E2值中,20 pg.mL-1〈E2≤30 pg.mL-1将会有低的用药量和好的妊娠结局;（2）降调节后月经第2日血清FSH/LH比值可用于预测卵巢的反应性;2〈FSH/LH≤3临床妊娠率最高。

The Value of Serum E_2 and FSH/LH Ratio in Predicting Ovarian Response and Assisted Reproduction Outcomes of Menstruation after Putuitary Down-regulation

Objective To investigate the value of the serum estradiol（E2） and follicle-stimulating hormone（FSH） to luteinizing hormone（LH） ratio at the commencement of stimulation to ovarian response in women unedrgoing putuitary down-regulation and controlled ovarian hyperstimulation with gonadt ropins in IVF or ICSI cycles.Methods 103 cycles of IVF/ICSI-ET which used pituitary down-regulation of mid-luteal were reviewed.103 cycles were divided into three groups according to the second day of menstruation affter putuitary down-regulation;group A： E2≤20 pg·mL-1,group B： 20 pg·mL-1E2≤30 pg·mL-1,group C： E2 30pg·mL-1.103 cycles were divided into four groups according to the FSH/LH ratio,group 1： FSH/LH ≤1,group 2： 1 FSH/LH≤2,group 3：2FSH/ LH ≤3,group 4：FSH/LH 3.the Dosage of Gn,duration of Gn,number of retrieved oocyte,number of mature oocytes,and clinical pregnancy rates among the groups were compared and analyzed.Results No significant difference in duration of Gn,number of retrieved oocyte,number of mature oocytes,and clinical pregnancy rates were found among group A,group B and group C（P0.05）.The higher FSH / LH ratio showed,the lower numbers of oocytes collected and mature follicles.The group with 2FSH and LH ≤3 had the highest clinical pregnancy cases（P0.05）.Conclusion The serum estradiol in the second day of menstruation affter putuitary down-regulation the group of 20 pg·mL-1 E2 ≤30 pg·mL-1will had a lower dosage and a better pregnancy outcome.The FSH /LH ratio could be used to predict the response of ovarian and the group with 2 FSH and LH ≤3 showed the best outcome of pregnancy.