卵泡刺激素黄体生成素比值与体外受精-胚胎移植结局的关系.doc

卵泡刺激素/黄体生成素比值与体外受精-胚胎移植结局的关系
作者：林文琴,杨海燕,陈霞,林金菊,叶碧绿
单位：温州医学院附属第一医院生殖医学中心，浙江温州325000
【摘要】目的：探讨体外受精-胚胎移植（invitrofertilization-embryotransfer，IVF-ET）治疗中卵泡刺激素/黄体生成素（FSH/LH）比值与IVF-ET结局的关系。方法:对基础卵泡刺激素（bFSH）在正常范围内（<12.5IU/L）148例不孕患者作前瞻性分析，超促排卵均采用促性腺激素释放激素激动剂（GnRH-a）/重组促卵泡激素（rFSH）/人绒毛膜促性腺激素（hCG）黄体期长方案。根据FSH/LH比值将患者分为两组：A组FSH/LH<2（n=87），B组FSH/LH≥2（n=61）。比较两组患者一般资料、卵巢反应性、IVF-ET结局。结果:两组患者年龄、bFSH值、移植胚胎数、受精率、种植率、临床妊娠率差异均无显著性（P>0.05），但A组患者基础促黄体生成素（bLH）值、hCG注射日E2峰值、直径≥14mm卵泡数、获卵数显著性高于B组（P<0.05）。Gn用量、周期取消率A组显著低于B组（P<0.05）。结论:FSH/LH≥2者卵巢反应性明显下降，FSH/LH比值是预测基础FSH尚在正常范围内卵巢反应性的一项较好指标。
【关键词】促性腺激素；体外受精；胚胎移植；妊娠结局
Relationshipbetweenfolliclestimulatinghormonetoluteinizinghormoneratioandtheoutcomeofinvitrofertilization-embryotransferLINWen-qin，YANGHai-yan，CHENXia，LINJin-ju，YEBi-lv.ReproductiveMedicineCenter，theFirstAffiliatedHospitalofWenzhouMedicalCollege，Wenzhou，325000
Abstract:Objective:Toevaluatetherelationshipbetweenbasalfolliclestimulatinghormonetoluteinizinghormone(FSH/LH)ratioandtheoutcomeofinvitrofertilization-embryotransfer(IVF-ET).Methods:148patientswithbasalFSHlevelinnomalrange（<12.5IU/L）werestudiedprospectively.AllpatientsreceivedGnRH-a/rFSH/humanchorionicgonadotrophin（hCG）protocolforIVF-ETtreatment.AccordingtothedifferentbasalFSH/LHratio，theyweredividedintotwogroups:87patientsasgroupA(FSH/LH<2)，61patientsasgroupB(FSH/LH≥2).Basaldatas，ovarianresponseandtheoutcomesofIVFwere
comparedbetweentwogroups.Results:Therewerenosignificantdifferencesinage，basalFSH，fertilityrate，thenumberoftransferredembryos，implatationrateandclinicalpregnancyratebetweentwogroups(P>0.05).However，thebasalLHlevel，theE2levelonthedayofHCG，thenumberoffollicles(≥14mm)andthenumberofoocytesobtainedingroupAweresignificantlyhigherthanthatingroupB，andtheamountofgonadotropin(Gn)used，poorresponserateweresignificantlylowerthanthatingroupB.Conclusion:BasalFSH/LHratio≥2reducestheovarianresponsetoGnsignificantly.TheBasalFSH/LHratiomaybeagoodpredictorofovarianresponseininfertilewomen