摘要
目的探讨多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者血清抗苗勒管激素(anti-Müllerian hormone,AMH)及体质量指数(body mass index,BMI)与接受体外受精(in vitro fertilization,IVF)/卵胞浆内单精子注射(intracytoplasmic sperm injection,ICSI)-胚胎移植(embryo transfer,ET)助孕过程中控制性促排卵结局的相关性。方法372例首次接受IVF/ICSI-ET助孕的PCOS患者均行控制性促排卵治疗,根据获卵数分为A组111例(获卵数≤10枚),B组156例(获卵数>10~<20枚),C组105例(获卵数≥20枚),采用Pearson相关分析法分析获卵数与控制性促排卵前血清AMH、BMI等的相关性。结果 C组MⅡ卵子数[(25.26±7.61)个]、2PN卵裂数[(15.77±7.36)个]及可利用胚胎数[(10.17±5.84)个]均高于B组(14.46±3.98)个、(9.96±3.83)个、(6.35±2.56)个]和A组[(7.51±2.35)个、(4.46±2.27)个、(3.62±1.75)个](P<0.05),B组高于A组(P<0.05);C组控制性促排卵前BMI[(23.23±3.22)kg/m^2]、促黄体生成素(luteinizing hormone,LH)[(7.25±3.29)u/L]、促性腺激素(gonadotropins,Gn)启动量[(111.07±21.39)u]均低于A组[(25.47±3.95)kg/m^2、(10.61±5.56)u/L、(125.68±27.31)u]和B组[(24.91±4.34)kg/m^2、(9.41±5.51)u/L、(126.44±24.96)u],血清AMH[(12.72±4.78)mg/L]高于A组[(8.56±4.74)mg/L]和B组[(9.43±4.76)mg/L](P<0.05),A组与B组比较差异无统计学意义(P>0.05),3组年龄、控制性促排卵前促卵泡激素(follicle stimulating hormone,FSH)、Gn使用时间、Gn总量比较差异均无统计学意义(P>0.05);Pearson偏相关分析结果显示,获卵数与控制性促排卵前AMH呈正相关(r=0.548,P<0.001),与控制性促排卵前LH及BMI呈负相关(r=-0.439,P=0.001;r=-0.426,P=0.026),AMH与BMI呈负相关(r=-0.217,P=0.016),LH与AMH、BMI无明显线性相关(r=0.154,P=0.088;r=-0.023,P=0.803)。结论血清AMH水平与PCOS患者IVF/ICSI-ET助孕过程中控制性促排卵结局呈正相关,BMI与控制性促排卵结局呈负相关。
Objective To explore the correlations of anti-Müllerian hormone（AMH）and body mass index（BMI）with controlled ovarian stimulation（COS）results in patients with polycystic ovary syndrome（PCOS）during retrieved oocyte number in in vitro fertilization/intracytoplasmic sperm injection and embryo transfer（IVF/ICSI-ET）.Methods A total of 372 patients with PCOS receiving IVF/ICSI-ET underwent the first IVF treatment,and were divided into group A（≤10 retrieved oocytes,n=111）,group B（〉10-〈20 retrieved oocytes,n=156）and group C（≥20 retrieved oocytes,n=105）based on the retrieved oocyte number.Pearson correlation analysis was adopted to analyze the correlations of the retrieved oocyte number with AMH and BMI before COS.Results The numbers of MⅡ oocytes（25.26±7.61）,cleavage 2 PN（15.77±7.36）and available embryos（10.17±5.84）in group C were significantly larger than those in group B（14.46±3.98,9.96±3.83,6.35±2.56）and group A（7.51±2.35,4.46±2.27,3.62±1.75）（P〈0.05）,and in group B than those in group A（P〈0.05）.The levels of BMI before COS（（23.23±3.22）kg/m2）,luteinizing hormone（LH）（（7.25±3.29）u/L）and starting dosage of gonadotropin（Gn）（（111.07±21.39）u）in group C were significantly lower than those in group A（（25.47±3.95）kg/m2,（10.61±5.56）u/L,（125.68±27.31）u）and group B（（24.91±4.34）kg/m2,（9.41±5.51）u/L,（126.44±24.96）u）,while the level of AMH（（12.72±4.78）mg/L）was significantly higher than that in group A（（8.56±4.74）mg/L）and group B（（9.43±4.76）mg/L）（P〈0.05）,and there was no significant difference between group A and B（P〉0.05）.There were no significant differences in the age,follicle stimulating hormone before COS,the applied duration of Gn and total dosage of Gn among three groups（P〉0.05）.Partial correlation analysis showed that the retrieved oocyte number was positively correlated with AMH（r=0.548,P〈0.001）,negatively with basal LH before COS and BMI（r=-0.439,P=0.001;r=-0.426,P=0.026）,AMH was negatively correlated with BMI（r=-0.217,P=0.016）before COS,and LH was not correlated with AMH and BMI（r=0.154,P=0.088;r=-0.023,P=0.803）.Conclusion AMH is positively and BMI is negatively correlated with COS results during IVF/ICSI-ET in patients with PCOS.
作者
路锦
李杭生
韦多
陈圆辉
张少娣
LU Jin;LI Hang-sheng;WEI Duo;CHEN Yuan-hui;ZHANG Shao-di(Reproductive Medical Center, Henan Provincial People＇s Hospital, People＇s Hospital of Zhengzhou University, Zhengzhou 450003, Chin)
出处
《中华实用诊断与治疗杂志》
2018年第6期529-532,共4页
Journal of Chinese Practical Diagnosis and Therapy
基金
国家自然科学基金(81401262)
关键词
多囊卵巢综合征
抗苗勒管激素
体质量指数
控制性促排卵
Polycystic ovary syndrome
anti-Mtullerian hormone
body mass index
controlled ovarian stimulation
