基础FSH/LH比值及晚卵泡期LH水平对体外受精-胚胎移植结局的影响

Effect of the Basal FSH:LH Ratio and LH Level in Late Follicle Phase on IVF Outcome

目的:探讨患者基础FSH/LH比值及控制性超促排卵(COH)时降调后hCG注射日血清LH水平对IVF-ET结局的影响及与COH各参数的关系。方法:回顾性分析首次进行IVF/ICSI-ET助孕、应用GnRH-a长方案降调节的不孕妇女,共427个周期。结果:ROC曲线显示FSH/LH比值与IVF-ET临床妊娠率无明显相关性;FSH/LH≥2与FSH/LH<2组间虽然临床妊娠率无差异,但FSH/LH≥2组Gn用量增加,获卵数少,优质胚胎数少,存在统计学差异(P<0.05)。hCG注射日血清LH≥0.65IU/L者妊娠率(55.8%)明显高于LH<0.65IU/L者(24.6%)。结论:基础FSH/LH比值增高能较早反映卵巢储备功能并指导超排方案及Gn用量;降调节后卵泡晚期(hCG注射日)的LH水平过低(<0.65IU/L),将会导致临床妊娠率下降。

Objective：To investigate the effects of the basal serum FSH：LH ratio and luteinizing hormone（LH） level in late follicle phase on IVF outcome.Methods：A retrospective analysis of 427 cycles using a long protocol with GnRH-a and rFSH was performed.Results：According to the ROC curve,the basal FSH：LH ratio had no significant effect on clinical pregnancy rate of IVF/ICSI treatment.In FSH/LH≥2 group,more gonadotropin was needed,less oocytes and good-quality embryo were obtained,when serum LH level ≥0.65 IU/L on the day of hCG injection,clinical pregnancy rate was significantly higher than that in LH〈0.65（55.8% vs 24.6%,P〈0.01）.Conclusion：Basal FSH：LH ratio is a better marker to predicate the ovarian reserve function and helpful for selection of the optimal controlled ovarian hyperstimulation（COH） protocol.Low LH concentrations（〈0.65 IU/L） during the late follicular phase might be detrimental to clinical pregnancy rate in IVF/ICSI treatment by long protocol.