基础睾酮水平对IVF-ET结局的影响

Outcome of pregnancy in IVF-ET under the influence of basal testosterone level

目的分析输卵管因素继发不孕妇女的体外受精-胚胎移植(IVF-ET)的助孕过程和结局,探讨基础睾酮(T)的重要性。方法回顾性分析30岁~35岁的123例第一周期长方案IVF-ET的不孕妇女的临床资料,根据新鲜周期的妊娠情况T水平的ROC曲线切割值、本中心对高T水平预降调至理想范围高值0.7ng/ml及T正常高值分成3组(A、B、C组),同种方式将同期输卵管因素继发不孕病例271例分成3组(Ⅰ、Ⅱ、Ⅲ组),分别比较组间助孕过程和妊娠结局。结果 A组2PN受精率、着床率、妊娠率、临床妊娠率明显低于B、C组(P<0.05);B组可利用胚胎率、优质胚胎率显著低于A、C组(P<0.05);Ⅰ组可利用胚胎数、成熟卵子率、着床率、妊娠率、临床妊娠率明显低于Ⅱ、Ⅲ组(P<0.05)。结论基础T水平较低时妊娠率明显下降。30岁~35岁妇女,基础T水平在0.45ng/ml^1.02ng/ml时能获得更好的妊娠结局。

Objective： To analyze the pregnant outcome after in vitro fertilization and embryo transfer （IVF - ET） in women with tubal factor secondary infertility, investigating importance of basal testosterone level. Methods ： One hundred and twenty - three women who undergoing the first cycle IVF - ET long scheme of sterility from thirty to thirty - five years old are studied retrospectively and split into three groups （ A, B, C）, according to fresh cycle of pregnancy situation testosterone level of ROC curve cutting value, ideal area high value of the center falling tone preliminarily high testosterone level and testosterone normal high value. By this way, two hun- dred and seventy - one ones are divided into three groups （ Ⅰ , Ⅱ, Ⅲ ）, compared respectively the process and pregnancy outcome. Results： 2PN fertilization rate, implantation rate and pregnancy rate and clinical pregnancy rate which were group A are significantly lower than that group B and C （ P 〈 0. 05 ） ; Group B are remarkable lower than the others between available embryo rate and high qual-ity embryos rate （ P 〈 0.05 ） ; About available embryo number, mature eggs rate, implantation rate pregnancy rate, clinical pregnancy rate, group I are lowest among the three groups （ P 〈 0.05 ）. Conclusions ： Lower basal has declined obviously on the pregnancy rate. The women between thirty and thirty - five years old can get better pregnancy outcome when basal testosterone level is from 0. 45 ng/ml to 1.02 ng/ml.