四种预测卵巢储备指标的临床研究

目的 :在体外受精 胚胎移植 (IVF ET)患者中对预测卵巢储备的 4种指标进行临床研究 ,以期寻找 1～ 2种灵敏度高的指标用于普通不孕人群。方法 :随机选择不同年龄段的 90例不孕患者 ,在接受IVF ET前 1～ 2个周期 ,于月经第 3天取空腹血测定基础性激素水平 ;于月经第 5～ 9天服氯米酚 (CC) 10 0mg,第 10天取空腹血测定FSH、LH、E2 ;开始进入IVF ET周期前 ,B超测量卵巢体积 ,观察IVF ET过程中卵巢的反应性。结果 :随年龄增加 ,卵巢反应不良及取消周期的比例增加 ;随基础FSH、服CC后FSH水平升高 ,卵巢反应性降低。卵巢体积较小组 ,卵巢反应不良的比例占 5 2 0 %。结论 :年龄是一个较为敏感的指标 ;基础FSH水平对卵巢储备的评估优于CC兴奋试验和卵巢体积测定。由于B超检查简便无侵入性 ,因此 ,认为基础FSH水平配合年龄和卵巢体积综合评估 ,将有助于提高预测价值。

Clinical Study on Four Predictors for Ovarian Reserve

Objective:To compare four predictors for ovarian reserve in patients receiving IVF-ET,in order to find out one or two higher sensitive predictors for common infertile women. Methods:90 patients with different ages were chosen randomly before undergoing IVF one or two cycles. The basal sexual hormone levels on the day 3 were measured. After taking clomiphene citrate (CC) 100 mg daily from day 5 to 9, serum levels of FSH, LH, and E2 on the day 10 were detected also. The ovarian volume in each woman was determined by transvaginal ultrasound before entering IVF program. Results:The proportion of poor ovarian response and the number of cancelled cycles were increased with the gain of women's age. The ovarian response decreased when the basal FSH levels and FSH levels after taking CC increased. The rate of poor ovarian response was 52.0% in women with small ovarian volume. Conclusions:Detection of basal FSH levels is superior to CC Challenge Test and the ovarian volume for assessing ovarian reserve. As the ultrasound is a simple and no invasive method, we suggested that the combination of basal FSH levels, women's age, and the ovarian volume should be helpful to improve the value of prediction.