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Impact of basal FSH/LH ratio on the ovarian response of young infertile women undergoing IVF/ET
林仙华;叶碧绿;赵军招;黄学锋;
摘要(Abstract)：
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。
关键词(KeyWords)： 滤泡刺激素;FSH/LH比值;卵巢储备功能
基金项目(Foundation):
作者(Authors): 林仙华;叶碧绿;赵军招;黄学锋;
DOI: 10.13283/j.cnki.xdfckjz.2006.12.013
参考文献(References)：
- [1]Kumbak B,Oral E,Kahraman S,et al.Young patients with diminished ovarian reserve undergoing assisted reproduc-tive treatments[J].Reprod Biomed Online,2005,11:294-299
- [21]Weghofer A,Margreiter M,Fauster Y,et al.Age-specific FSHlevels as a tool for appropriate patient counselling in assisted reproduction[J].Hum Reprod,2005,20:2448-2452
- [3]彭谢东,徐军,韩金兰,等.基础FSH/LH比值与控制性超促排卵结果的关系[J].复旦学报(医学版),2004,31:176-178
- [4]Shrim A,Elizur SE,Seidman DS,et al.Elevated day3FSH/LHratio due to low LH concentrations predicts re-duced ovarian response[J].Reprod Biomed Online,2006,12:418-422
- [5]林金菊,叶碧绿,周颖,等.体外受精-胚胎移植治疗不孕症临床分析[J].温州医学院学报,1999,29:267-269
- [6]黄学锋,郑菊芬,李橙棣,等.单精子卵胞浆内注射术治疗男性不孕症探讨[J].泌尿外科杂志,2000,38:456-458
- [7]周颖,叶碧绿,黄学锋,等.卵胞浆内单精子注射和常规体外受精-胚胎移植的胚胎形态及临床结果比较[J].生殖医学杂志,2001,10:24-28
- [8]黄荷风.现代辅助生育技术[M].北京:人民卫生出版社,2003:143
- [9]Chae HD,Kim CH,Kang BM.et al.Clinical usefulness of basal FSHas a prognostic factor in patients undergoing in-tracytoplasmic sperm injection[J].J Obstet Gynecol Res,2000,26:55-60
- [10]Bancsi LF,Huijs AM,derr Ounden CT,et al.Basal folli-cle-stimulating hormone levels are of limited value in predicting ongoing pregnancy rates after in vitro fertiliza-tion[J].Fertil Steril,2000,73:552-557
- [11]Mukherjee T,Coppeman AB,Lapinski R.An elevated day three follicle-stimulating hormone:luteinizing hor-mone ratio(FSH:LH)in the presence of a normal day3FSHpredicts a poor response to controlled ovarian hy-perstimulation[J].Fertil Steril,1996,65:588-593
- [12]Esposito MA,Coutifaris C,Barnhart KT.A moderately elevated day3FSHconcentration has limited predictive value,especially in younger women[J].Hum Reprod,2002,17:118-123