5865例IVF/ICSI-ET患者基础窦卵泡数预测卵巢储备功能的价值

目的:探索基础窦卵泡数(antralfolliclecount,AFC)预测卵巢储备功能的价值。方法:回顾性分析5865例应用长方案行IVF/ICSI-ET患者的临床资料。结果:①AFC与Gn用量呈非常显著负相关(r=-0.47,P<0.05),与成熟卵泡呈显著正相关(r=0.53,P<0.05)。②AFC预测卵巢反应不良率及妊娠率的ROC曲线下面积AUCl、AUC2值分别为0.86(95%CI=0.84～0.88)及0.56(95%CI=0.54～0.57),均显著大于参考值(P均<0.05)。并且,AUCl>AUC2,差异有统计学意义(Z=19.5,P<0.05)。③依据ROC曲线计算AFC预测卵巢储备功能的截断值为<10。AFC≥10组的Gn用量以及卵巢反应不良率均低于AFC<10组,差异显著(P<0.05);AFC≥10组的成熟卵泡数及妊娠率均高于AFC<10组,差异显著(P<0.05)。结论:AFC是一良好的评估卵巢储备功能的指标。且对于卵巢反应性的预测价值优于对IVF结局的预测。AFC预测卵巢储备功能的界定值为<10。

Value of Antral Follicle Count on Predicting the Ovarian Reserve in 5 865 Women Undergoing IVF/ICSI-ET

Objective：To investigate the predicting value of antral follicle count（AFC） on ovarian reserve in women undergoing IVF/ICSI-ET.Methods：A total of 5865 long protocol IVF/ICSI-ET cycles were analyzed retrospectively.Results：AFC was negatively correlated to the number of Gn（r=-0.47,P〈0.05） and positively related to the number of mature follicles（r=0.53,P〈0.05）.The areas under ROC curve（AUC） of AFC for predicting the poor response rate,clinical pregnancy rate were 0.86,0.56,respectively,which were both larger than those under the diagnosis reference line（P〈0.05）.There was a significant difference on AUC between the two investigators（Z=19.5,P〈0.05）.The AFC cutoff value was correspondent to 9 by plotting the ROC curve.The patients were divided into two groups：AFC≥10 and AFC〈10.The patients AFC〈10 needed larger amount of gonadotrophin and had lower number of mature follicle,and tended to have higher poor response rate and lower pregnancy rates.Conclusion：AFC is a good predictor of ovarian reserve.And the AFC is better at predicting the response to gonadotrophin stimulation than the chance of pregnancy.The AFC cutoff value for predicting ovarian reserve was correspondent to10.