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

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。

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 （237 cycles） 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 E2 level, clinical pregnancy rate were compared among three groups. Results： No significant differences were found among three groups in age, antra follicle count, basal E2 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 E2 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 E2, 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 E2, 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.