少弱精子症患者血清INHB对IVF临床妊娠结局的预测价值

Predictive value of serum INHB in patients with oligoasthenozoospermia on IVF clinical pregnancy outcomes

目的研究血清抑制素B(INHB)对少弱精子症行体外受精(IVF)临床妊娠的预测价值。方法纳入100对行IVF且妊娠成功的夫妇作为妊娠成功组,另纳入100对行IVF且妊娠失败的夫妇为妊娠失败组。采用Pearson分析男方血清INHB与精液参数及血清促卵泡激素(FSH)的关系,用logistic法分析影响行IVF患者妊娠结局的危险因素,以受试者工作特征(ROC)曲线分析血清INHB对患者临床妊娠结局的预测价值。结果Pearson相关分析显示血清INHB与精子密度(r=0.424,P<0.001)、精子活动率(r=0.207,P=0.003)及精子总数(r=0.587,P<0.001)呈正相关,而与血清FSH(r=-0.568,P<0.001)呈负相关。logistic回归分析显示,男方年龄、BMI、不良生活习惯、血清FSH、血清INHB、精子活力及精子密度均是影响少弱精子症患者行IVF临床妊娠结局的独立危险因素(P<0.05)。以血清INHB=95.60 pg/mL作为预测的临界值,ROC曲线下面积(AUC)为0.865,灵敏度为76.6%,特异度为82.3%。结论血清INHB与少弱精子症行IVF患者的精液参数及FSH密切相关,对IVF临床妊娠结局具有一定的预测价值。

Objective To study the predictive value of serum inhibin B(INHB)for clinical pregnancy in the oligospermia patients undergoing in vitro fertilization(IVF).Methods A total of 100 couples who underwent IVF and had a successful pregnancy were included as the successful pregnancy group,while another 100 pairs of couples who underwent IVF and failed pregnancy were included in the pregnancy failure group.Pearson analyse method was used to analyze the relationship between male serum INHB and semen parameters and serum follicle stimulating hormone(FSH).Logistic method was used to analyze the risk factors of pregnancy outcomes in the patients undergoing IVF.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum INHB to judge the clinical pregnancy outcomes.Results Pearson correlation analyse showed that the serum INHB was positively correlated with the sperm density(r=0.424,P<0.001),sperm motility rate(r=0.207,P=0.003)and total sperm count(r=0.587,P<0.001),but negatively correlated with the serum FSH(r=-0.568,P<0.001).Logistic regression analysis showed that the male′s age,BMI,bad living habits,serum FSH,serum INHB,sperm motility and sperm density were the independent risk factors for the success of IVF in the oligospermia patients(P<0.05).Taking serum INHB=95.60 pg/mL as the critical value for prediction,the area under the ROC curve(AUC)was 0.865,the sensitivity was 76.6%,and the specificity was 82.3%.Conclusion Serum INHB is closely related to semen parameters and FSH of the patients with oligospermia undergoing IVF.It has a certain predictive value for the IVF clinical pregnancy outcome.