长方案超促排卵过程中晚卵泡期黄体生成素/Gn启动前黄体生成素比值对体外受精妊娠结局的预测价值

Value of luteinizing hormone ratio during late follicular phase / gonadotropin start in prediction of pregnancy outcome of in vitro fertilization-embryo transplantation in the course of controlled ovarian hyperstimulation using long protocol

目的探讨卵巢储备功能正常的不孕症患者在长方案控制性超促排卵(COH)周期中卵泡发育晚期血清LH/降调节后Gn启动前的LH(LH晚/LH0)比值对体外受精-胚胎移植(IVF-ET)妊娠结局的预测价值。方法回顾性分析118例首次接受长方案COH且卵巢储备能力正常患者的临床资料,采用受试者工作特征曲线(ROC)筛选LH晚/LH0比值对妊娠结局预测的最佳阈值并根据该阈值进行分组即LH晚/LH0≤1组(A组)和LH晚/LH0>1组(B组),比较组间的临床参数,采用Logistic回归分析研究LH晚/LH0比值和临床妊娠之间的关系。结果长方案中LH晚/LH0比值最佳阈值为1.0,B组临床妊娠率明显高于A组,差异有统计学意义(χ2=19.34,P<0.01)。Logistic回归分析结果显示LH晚/LH0比值可以作为一个独立的临床妊娠结局的预测指标。结论对卵巢储备能力正常且采用长方案COH治疗的患者,LH晚/LH0比值>1.0者临床妊娠率明显增高,该比值对IVF妊娠结局具有一定的预测价值。

Objective To explore the value of luteinizing hormone（ LH） ratio（ LHlate/ LH0） during late follicular phase/gonadotropin（ Gn） start in prediction of pregnancy outcome of in vitro fertilization-embryo transplantation（ IVF-ET） in the course of controlled ovarian hyperstimulation（ COH） using long protocol among infertile patients with normal ovarian reserve function. Methods The clinical data of118 patients with normal ovarian reserve function receiving long protocol COH for the first time were analyzed retrospectively,ROC was used to screen the optimal threshold value of LHlate/ LH0 for predicting pregnancy outcome,then the cases were divided into group A（ LHlate/LH0≤1） and group B（ LHlate/ LH01） according to the threshold value; the clinical parameters in the two groups were compared; logistic regression analysis was used to research the relationship between LHlate/ LH0 ratio and clinical pregnancy. Results The optimal threshold value of LHlate/ LH0 in long protocol was 1. 0,the clinical pregnancy rate in group B was statistically significantly higher than that in group A（ χ2= 19. 34,P〈0. 01）. Logistic regression analysis showed that LHlate/ LH0 ratio could be used as an independent predictor for clinical pregnancy outcome of the patients. Conclusion Among the patients with normal ovarian reserve function receiving long protocol COH,the clinical pregnancy rate is high in the patients with LHlate/ LH0ratio1. 0,LHlate/ LH0 ratio has a certain predictive value for IVF pregnancy outcome.