血清AMH、E_(2)、P/获卵数对IVF-ET患者妊娠失败的预测价值

Prognostic Value of Pregnancy Failure in IVF-ET Patients with Serum AMH,E_(2),P to Number of Aspirated Oocytes Ratio

目的 探讨人绒毛膜促性腺激素(hCG)注射日血清抗米勒管激素(AMH)、雌二醇(E_(2))、孕酮(P)/获卵数水平对体外受精-胚胎移植(IVF-ET)术后妊娠失败的预测价值。方法 回顾性分析在郑州大学第一附属医院接受IVF-ET治疗的80例不孕症患者的临床资料,根据妊娠结局分为妊娠成功组和妊娠失败组。统计患者妊娠失败率,对比妊娠失败组与妊娠成功组hCG注射日血清AMH、E_(2)及P/获卵数水平,并采用受试者工作特征(ROC)曲线分析hCG注射日血清AMH、E_(2)、P/获卵数对患者IVF-ET术后妊娠失败的预测价值。结果 不孕症患者IVF-ET术后的妊娠失败率为52.50%,妊娠失败组hCG注射日血清AMH水平低于妊娠成功组(P<0.05),E_(2)、P/获卵数水平均高于妊娠成功组(P<0.05);血清AMH、E_(2)、P/获卵数水平预测患者IVF-ET术后妊娠失败的cut-off值分别为3.69μg·L^(-1)、989.00 pmol·L^(-1)、0.28,三者联合预测患者IVF-ET术后妊娠失败的灵敏度、特异度、曲线下面积(AUC)分别为95.24%、86.84%、0.866,AUC均高于单独预测,差异有统计学意义(P<0.05)。结论 IVF-ET术后妊娠失败患者hCG注射日血清AMH水平较低,E_(2)、P/获卵数水平较高,血清AMH、E_(2)、P/获卵数水平联合对患者IVF-ET术后妊娠失败的预测价值高,可用于指导治疗。

Objective To investigate the value of serum anti-Müllerian hormone(AMH),estradiol(E_(2)),progesterone(P)to number of aspirated oocytes ratio on injection of human chorionic gonadotropin(hCG)day for pregnancy failure in vitro fertilization-embryo transfer(IVF-ET).Methods The clinical data of 80 infertility patients who underwent IVF-ET in the First Affiliated Hospital of Zhengzhou University were analyzed retrospectively,and patients were divided into the pregnancy success group and the pregnancy failure group according to the pregnancy outcomes.The pregnancy failure rate of the patients was calculated,and the serum AMH,E_(2) levels and P to number of aspirated oocytes ratio were compared between the pregnancy failure group and the pregnancy success group on hCG injection day,and the predictive value of serum AMH,E_(2),P to number of aspirated oocytes ratio on hCG injection days for patients pregnancy failure after IVF-ET were analyzed by receiver operating characteristic(ROC)curve.Results The pregnancy failure rate of infertility patients after IVF-ET was 52.50%.Serum AMH level on hCG injection day in the pregnancy failure group was lower than that in the pregnancy success group(P<0.05),while E_(2) and P to a number of aspirated oocytes ratio were higher than those in the pregnancy success group(P<0.05).The cut-off values of serum AMH,E_(2) and P to number of aspirated oocytes ratio to predict patients pregnancy failure after IVF-ET were 3.69μg·L^(-1),989.00 pmol·L^(-1) and 0.28,respectively.The sensitivity,specificity and area under the curve(AUC)of combined prediction of pregnancy failure after IVF-ET were 95.24%,86.84%and 0.866,respectively.AUC was higher than those of single prediction,and the differences were statistically significant(P<0.05).Conclusion The serum AMH level of pregnancy failed patients after IVF-ETon hCG injection day is low,E_(2) and P to number of aspirated oocytes ratio are high,and serum AMH level combined with E_(2) and P to a number of aspirated oocytes ratio have high predictive value for pregnancy failure after IVF-ET,which can be used for guiding treatment.