摘要
目的通过测定体外受精-胚胎移植治疗周期的不孕症患者血清内抑制素B的水平变化，预测卵巢的反应性，为选择最佳的超促排卵方案提供理论依据。方法选择接受体外受精-胚胎移植治疗的妇女63例，在治疗的不同阶段分别抽取外周静脉血，应用酶联免疫吸附法检测血清中抑制素B的浓度变化，记录相应患者年龄、获卵数、月经周期第2天雌二醇水平、卵泡刺激素水平及胚胎移植结局，并根据获卵数，将63例患者分为卵巢低反应组（A组）及正常反应组（B组），比较两组注射重组卵泡刺激素后抑制素B水平的变化及其与获卵数、妊娠结局的相关性。结果①两组患者均未发生卵巢过度刺激综合征，其年龄比较无统计学意义（t=1．926，P=0．358）；②A组与B组月经周期第2天血清抑制素B水平分别为：45．80±29．53pg／mL、87．60±30．94pg／mL，A组显著低于B组，经比较差异有统计学意义（f=-4．615，P=0．000）。A组与B组月经周期第2天血清卵泡刺激素水平分别为：8．88±2．76mU／mL、6．68±2．08mU／mL，A组显著高于B组，经比较差异有统计学意义（t=2．850，P=0．010）；③A组和B组注射重组卵泡刺激素后5天，患者血清抑制素B水平分别为132．27±18．45pg／mL、169．83±51．04pg／mL，A组显著低于B组，经比较差异有统计学意义（t=-4．282，P=0．000）。A组和B组注射人绒毛膜促性腺激素当日患者血清抑制素B水平分别为205．77±40．70pg／mL；④患者获卵数与月经周期第2天血清抑制素B水平、注射卵泡刺激素第5天血清抑制素B水平呈显著正相关（r分别为0．502、0．307，P分另4为0．000、0．014）。结论月经周期第2天血清卵泡刺激素、抑制素B水平均可预测卵巢的反应性，而血清抑制素B水平具有更高的预测价值；经卵泡刺激素刺激后第5天，血清抑制素B水平能较敏感地预测卵巢对重组卵泡刺激素刺激的反应性。
Objective To preditict ovarian response through detecting serum level of inhibin B （ INH B ） of infertile women who were receving controlled ovarian hyperstimulation （COH） for IVF-ET so as to provide a theoretical basis for choosing an optimal COH programm. Methods 63 patients undergoing their first cycle of IVF-ET treatment were selected and their serum levels of E2, FSH and INH B in peripheral vein blood were detected on day 2 of the cycle, on day 5 of gonadotropin therapy, hCG injection day. At the same time, age of the patient, number of oocytes retrieved and outcome of ET were recorded. According to number of oocytes retrieved, all 63 patients were divided into two groups ： poor ovarian response group （ group A, n = 15 ） and normal ovarian response group （ group B, n = 48 ）. The serum levels of INH B after injection of recombinant FSH of patients in the two groups were compared and relationships of serum levels of INH B with number of oocytes retrieved and pregnancy outcomes were analyzed. Results （1）All 63 patients had not ovarian hyperstimulation syndrome （OHSS）. Between group A and group B, in age of the patient, there was no significant difference （33.2 ±3.5yrs. vs 32. 1 ±4. 3yrs., t = 1. 926 ,P =0. 358） ; （2）In INH B level on day 2 of menstrul cycle （45.80±29.53pg/mL in group A and 87.60 ± 30.94pg/mL in group B） , there was a significant difference between the two groups （ P = 0. 000 ）. The serum level of FSH on day 2 of menstrul cycle in group A （8.88 ± 2.76mU/mL） was significantly higher than that in group B （ 6.68±2.08mU/mL） （t = 2. 850 ,P = 0.010 ）. But in E2 level on day 2 of menstrul cycle, there was no significant difference between the two groups （ t = - 2. 660, P = 0.791 ） ; （3）Tbe serum level of INH B of patients on day 5 of recombinant FSH injection in group A （ 132.27 ± 18.45pg/mL） was significantly lower than that in group B （169.83 ±51.04pg/mL） （t = -4. 282,P = 0. 000）. In serum level of INH B on the day of hCG injection, there was no significant difference between the two groups （205.77 ± 40.70pg/mL vs 196.45 ± 71.29pg/mL, t = 0. 476, P = 0. 636 ） ; （4）The number of oocytes retrieved was significantly correlated with serum levels of INH B on day 2 of menstrual cycle and on day 5 of FSH injection （r = 0.502 and 0.307 respectively;P =0.000 and 0. 014 respectively）. Conclusion The serum levels of FSH and INH B on the 2nd day of menstruaal cycle all can predict ovarian response, but the serum level of INH B shows higher predictive value. On the 5th day after FSH stimulation, the serum level of INH B can still sensitively predict the ovarian response to recombinant FSH.
出处
《中国妇幼健康研究》
2009年第3期294-296,共3页
Chinese Journal of Woman and Child Health Research
基金
[基金项目]新疆维吾尔自治区自然科学基金资助项目（2000E-012）
关键词
抑制素B
体外受精-胚胎移植
不孕症
控制性超排卵
inhibin B （INH B）
in vitro fertilization and embryo transfer（IVF-ET）
infertility
controlled ovarian hyperstimulation （COH）
