精浆AMH、INHB、血清INHB对常规IVF受精结局的预测价值

Seminal plasma anti-Müllerian hormone and inhibin B and serum inhibin B in predicting the outcome of routine IVF fertilization

目的:分析精浆AMH、INHB及血清INHB与少弱精子症患者精液参数之间的相关性,同时探讨对其常规体外受精(IVF)结局的预测价值及影响。方法:收集2016年8月至2017年2月因男方少弱精子症或女方输卵管因素就诊于宁夏医科大学总医院生殖中心行IVF助孕的88例不孕夫妇的临床资料,检测精浆AMH、INHB、血清INHB及精液参数(精子活动率、浓度、总数、前向运动精子百分率及正常形态精子百分率),采用受试者工作特征曲线(ROC)分析精浆AMH、INHB、血清INHB及精液参数对其受精率的预测能力;Pearson相关分析检验精浆AMH、INHB及血清INHB与精液参数之间的关系,均设定P<0.05为有统计学差异。结果:精浆AMH:AUC=0.807(敏感度84.6%,特异度76.0%,截断点3.529,P=0.000),精浆INHB:AUC=0.768(敏感度84.6%,特异度88.7%,截断点31.117,P=0.002);血清INHB与精子浓度(r=0.346,P=0.001)、精子总数(r=0.378,P=0.000)、精子活动率(r=0.521,P=0.000)、前向运动(r=0.343,P=0.001)。结论:精浆AMH、INHB可作为预测少弱精子症患者受精率的实验室指标;血清INHB与少弱精子症精液参数(精子浓度、精子总数、活动率及前向运动精子百分率)呈显著正相关。

Objective： To analyze the correlations of seminal plasma （sp） anti-Mtillerian hormone （spAMH） and inhibin B （spINHB） and serum INHB （serINHB） with semen parameters in oligoasthenospermia patients and explore their value in predicting the outcome of routine in vitro fertilization （IVF）. Methods ： We obtained the levels of spAMH, splNHB and serINHB as well as se- men parameters from 88 infertile males undergoing IVF due to oligoasthenospermia or female uterine tubM factors from August 2016 to February 2017. Using the ROC curve and Pearsong correlation analysis, we examined the effects of the obtained parameters on the fer- tilization rate and assessed the correlation of the levels of spAMH, spINHB and serINHB with the semen parameters of the patients. Results： Concerning the predictive value for the outcome of IVF, Pearson ; correlation analysis showed that the area under the ROC curve （AUC） of spAMH was 0. 807 （sensitivity = 84.6%, specificity = 76%, cut-off point = 3. 529, P 〈0. 001 ） and that of splNHB was 0.768 （sensitivity = 84.6%, specificity = 88.7%, cut-off point = 31.117, P = 0. 002）. The serlNHB level was found positively correlated with sperm concentration （r = 0. 346, P = 0. 001 ）, total sperm count （r = 0. 378, P 〈 0. 001 ）, sperm motility （r = 0.521, P 〈0.001）, and the percentage of progressively motile sperm （r = 0.343, P = 0.001）. Conclusion： The levels of spAMH and spINHB can be used as laboratory indexes to predict the fertilization rate of routine IVF and are con＇elated with se- men parameters in oligoasthenospermia patients, while that of serINHB has a positive correlation with the semen parameters of the pa- tients.