卵泡敏感指数预测体外受精/卵胞质内单精子显微注射患者妊娠结局的价值

Value of follicle sensitivity index in predicting the pregnancy outcomes in patients with in vitro fertilization/intracytoplasmic sperm injection

目的探讨卵泡敏感指数(follicular sensitivity index,FSI)预测接受体外受精(IVF)/卵胞质内单精子显微注射(ICSI)-胚胎移植(ET)患者临床结局的价值。方法选择2009年4月至2015年12月苏北人民医院生殖中心行IVF/ICSI-ET的不孕症妇女,选择长方案促排卵治疗,最终纳入1218个取卵周期,1946个移植周期,共分为3组:低FSI组(397个周期)、中FSI组(415个周期)、高FSI组(406个周期)。比较3组患者数据,评价FSI与治疗结局的相关性。结果FSI的受试者工作特征(ROC)曲线下面积为0.644。高FSI组女性排卵前卵泡数(PFC)、卵泡输出率(FORT)、获卵数、优质胚胎数、可移植胚胎数、种植率、活产率、累计妊娠率较高,3组间这些指标的差异具有统计学意义(P均<0.05)。多因素分析显示促性腺激素(Gn)使用总量、PFC及年龄是对FSI具有统计学意义的指标(P<0.05)。结论FSI是IVF/ICSI-ET治疗中预测妊娠结局的有效指标,FSI高的患者具有较理想的妊娠结局。

Objective To investigate the value of follicular sensitivity index(FSI)in predicting the pregnancy outcomes in patients undergoing in vitro fertilization(IVF)/intracytoplasmic sperm injection(ICSI)-embryo transfer(ET).Methods The data of infertility women undergoing the IVF/ICSI-ET in the Reproductive Center of the North Jiangsu People’s Hospital from April 2009 to December 2015 were collected.Only long-term ovulation treatment was adopted,and finally 1218 egg-taking cycles and 1946 transplantation cycles were included.Those women were grouped into three groups:the low FSI group(397 cycles),the medium FSI group(415 cycles)and the high FSI group(406 cycles).Patients’data of three groups were compared to evaluate the association between FSI and treatment outcome.Results The area under the receiver operating characteristic(ROC)curve of FSI was 0.644.In the high FSI group,preovulatory follicle count(PFC),follicle output rate(FORT),number of retrieved oocytes,number of high-quality embryos,number of transplantable embryos,planting rate,live birth rate,and cumulative pregnancy rate were higher than those in the low FSI group and the medium FSI group.The difference among the three groups was statistically significant(P<0.05).Multivariate analysis showed that total gonadotropin(Gn),PFC and age were statistically significant for FSI(P<0.05).Conclusion FSI is an effective predictor of pregnancy outcome in IVF/ICSI-ET treatment,and patients with high FSI have an ideal pregnancy outcome.