基础血清卵泡刺激素/黄体生成素比值评估卵巢反应性价值的探讨

Analysis of the significance of basal follicle stimulating hormone/luteinizing hormone ratio in the assessment of ovarian response

目的探讨基础卵泡刺激素/黄体生成素(FSH/LH)比值评估卵巢对促性腺激素反应性的价值。方法对134个短方案促排卵周期的患者年龄、基础FSH以及FSH/LH比值和代表卵巢反应性降低的指标进行logistic回归统计,比较三者影响度,并寻找适当FSH/LH界值。结果在基础FSH<8 IU/L患者中,年龄、FSH和FSH/LH比值对卵巢反应性降低的影响度OR值相近,基础FSH/LH预测取卵数目≤5个的界值为3.7;在FSH≥8 IU/L患者中,上述三项指标OR值出现差异,FSH/LH比值的OR值最高,年龄次之,FSH最低;基础FSH/LH预测取卵数目≤5个的界值为3.3。结论在卵巢储备降低(FSH≥8 IU/L)的患者中,使用基础FSH/LH比值对卵巢反应性进行评估比单纯使用年龄或基础FSH进行评估更有价值。

Objective： To analyze the value of basal follicle stimulating hormone-to-luteinizing hormone （bFSH/LH） ratio in the assessment of ovarian response to gonadotrophin stimulation. Methods： One hundred and thirty-four patients underwent IVF-ET or ICSI using a short protocol for superovulation. We studied their age, basal FsH/LH ratio and some indexes which can represent ovarian response. Statistical evaluation was performed using logistic regression analysis and ROC curve was used to determine odds ratios（OR） and FSH/LH cutoffs. Results： In the patients with basal FSH less than 8 IU/L, three odds ratios between the ovarian response index and their age, basal FSH, basal FSH/LH were of no significant difference and basal FSH/LH cutoff was 3.7. But among the patients with basal FSH ≥8 IU/L, there were differences of these three OR and basal FSH/LH cutoff was 3.3. The highest OR was found between basal FSH/LH ratio and ovarian response indexes, while the lowest was between basal FSH and those ovarian response indexes. Conclusion： Among the patients who has lower ovary reserve （basal FSH ≥ 8 IU/L）, the basal FSH/LH ratio has a superior significance to age and basal FSH on evaluating ovarian response.