基础FSH/LH比值对预测年轻不孕患者IVF-ET周期卵巢反应性的影响

目的:探讨基础FSH和LH比值预测基础FSH水平正常且年轻不孕患者卵巢反应性的临床价值。方法:回顾分析2004年6月至2005年5月因男方因素或输卵管因素行体外受精-胚胎移植(in-vitrofertilization-embryotransfer,IVF-ET)治疗的年轻(年龄≤35岁)且基础FSH水平正常(≤8.5IU/L)不孕患者237例的临床资料,共计237个治疗周期,依据FSH/LH不同比例分为3组,A组(n=44)FSH/LH<1;B组(n=143)FSH/LH12;C组(n=50)FSH/LH>2。比较各组间的年龄、激素水平、卵巢反应、IVF的实验室结果以及妊娠情况。结果:3组患者的年龄、窦卵泡数、基础E2值、受精率、卵裂率和妊娠率两两相比无统计学差异(P>0.05),但A、B两组间的基础FSH值、基础LH值、E2峰值和成熟卵泡数差异有统计学意义(P<0.05);A、C两组间基础FSH值、基础LH值、E2峰值、促性腺激素(gonadotropin,Gn)总用量、Gn平均每日用量、Gn用药时间及获卵数和成熟卵泡数的差异有统计学意义(P<0.05);B、C两组间基础LH值、E2峰值、促性腺激素总用量、Gn平均每日用量和Gn用药时间比较也有明显差异(P<0.05)。结论:FSH正常的年轻妇女,FSH/LH>2的卵巢反应性明显低于FSH/LH<1者;FSH/LH比值是预测基础FSH正常且年轻不孕者卵巢反应性的一项较好指标。

Impact of basal FSH/LH ratio on the ovarian response of young infertile women undergoing IVF/ET

Objective:To investigate the predictive significance of basal FSH /LH ratio for ovarian response in young infertile women whose basal FSH level were normal.Methods:Two hundred and thirty seven women undergoing in-vitro fertilization-embryo transfer (IVF-ET) due to male or fallopian tube factors in the First Hospital of Wenzhou Medical College from June 2004 to May 2005 were studied retrospectively.According to the different basal FSH /LH ratio,the total 237 cases(237cycles)were divided into three groups:44 women as group A ( FSH/ LH <1),143 women as group B( FSH /LH 1-2) and 50 women as group C ( FSH/LH>2).Age,hormone level,antra follicle count,basal E_2 level,clinical pregnancy rate were compared among three groups.Results:No significant differences were found among three groups in age,antra follicle count,basal E_2 level,fertility rate,cleavage rate and clinical pregnancy rate(P>0.05).However,there were significant differences between group A and group B in basal FSH level,basal LH level,the peak level of E_2 and the number of mature follicles(diameter ≥14mm) (P<0.05).When comparing group A with group C ,there were significant differences in basal FSH level,basal LH level,the peak level of E_2,the numbers of mature follicles(diameter ≥14mm),the numbers of oocytes obtained,the total dosage of gonadotropin,the mean dosage of gonadotropin used per day,the duration of gonadotropin administration(P<0.05).There was also obvious different between group B and group C in basal LH level,the peak level of E_2,the total dosage of gonadotropin,the mean dosage of gonadotropin used per day,the duration of gonadotropin administration(P<0.05).Conclusion:Among young infertility women whose basal FSH levels are normal,basal FSH/LH ratio>2 predicts poor response of ovary.The basal FSH/LH ratio may be a good predictor of ovarian response in young infertile women with normal basal FSH level.