摘要
目的:探讨不孕症行体外受精或卵母细胞卵胞浆内单精子显微注射-胚胎移植(IVF/ICSI-ET)女性抗苗勒氏管激素(AMH)、促甲状腺激素(TSH)、卵泡输出率(FORT)水平及预测妊娠结局价值。方法:收集2018年1月-2022年6月本院辅助生殖医学中心收治的407例行IVF/ICSI-ET治疗的不孕症患者临床资料,根据IVF/ICSI-ET治疗后妊娠结局分为妊娠组228例和未妊娠组179例。在IVF/ICSI-ET启动前一周期的月经第2 d天检测患者AMH及TSH水平,行阴道超声检查卵泡情况计算FORT,并与获卵数目、卵子成熟率、受精率、优质胚胎率的相关性,以受试者工作特征曲线(ROC)分析预测卵泡发育及妊娠结局价值。结果:妊娠组AMH水平(5.12±1.53 ng/ml)高于未妊娠组(3.66±1.14 ng/ml),TSH水平(2.19±0.60 mU/L)低于未妊娠组(2.87±0.85 mU/L),FORT(90.42±6.28)%高于未妊娠组(81.36±8.53)%(均P<0.05)。AMH与获卵数目、卵子成熟率呈正相关,TSH与获卵数目呈负相关,FORT与获卵数目呈正相关(均P<0.05)。AMH、TSH及FORT预测妊娠结局的曲线下面积分别为0.791、0.744、0.836,灵敏度分别为72.5%、70.3%、86.8%,特异度77.8%、66.7%、69.4%。结论:不孕症女性AMH、TSH、FORT与IVF/ICSI-ET获卵数目、卵子成熟率具有关联,对妊娠结局有一定的预测价值。
Objective:To analysis the evels of anti mullerian hormone(AMH)and thyroid stimulating hormone(TSH),and follicular output rate(FORT)of infertile women after in vitro fertilization/intracytoplasmic sperm injection embryo transfer(IVF/ICSI-ET),and to study their predictive values for the pregnancy outcomes of the women.Methods:The clinical data of 407infertility women after IVF/ICSI-ET in the reproductive medicine department assisted reproductive center of the hospital between January 2018and June 2022were collected.According to the pregnancy outcomes of the women after IVF/ICSI-ET,these women were divided into group A(228cases with pregnancy)and group B(179cases without pregnancy).The levels of AMH and TSH of the women in the two groups on the second day of the menstrual cycle before the start of IVF/ICSI-ET were detected.FORT was calculated based on the follicle situation by transvaginal ultrasonography,and the correlation between which and the egg number,the ovum maturity rate,the fertilization rate,and the quality embryo rate of the women was analyzed.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of FORT for the follicle development and the pregnancy outcomes of the women.Results:The AMH level of the women in group A was significantly higher than that of the women in group B,the TSH level of the women in group A was significantly lower than that of the women in group B,and the value of FORT of the women in group A was significantly higher than that of the women in group B(all P<0.05).The AMH level of the women was positively correlated with their number of oocytes retrieved and their rate of oocyte maturation,the TSH level of the women was negatively correlated with the number of their oocytes retrieved,and the FORT value was positively correlated with their number of oocytes retrieved(all P<0.05).The area under curve of the levels of AMH and TSH,and the FORT value of the women for predicting their pregnancy outcomes were 0.791,0.744,and 0.836,respectively,the sensitivity of which were 72.5%,70.3%,and 86.8%,respectively,and the specificity of which were 77.8%,66.7%,and 69.4%,respectively.Conclusion:The levels of AMH and TSH,and the FORT value of the infertility women are correlated with the number of their oocytes retrieved and their rate of their oocyte maturation after IVF/ICSI-ET,which has certain predictive values for the pregnancy outcomes of the women.
作者
侯东升
郭艳霞
孙昕卉
郭虹敏
李辉
HOU Dongsheng;GUO Yanxia;SUN Xinhui;GUO Hongmin;LI Hui(Liaocheng People's Hospital,Liaocheng,Shandong Province,252000)
出处
《中国计划生育学杂志》
2023年第6期1384-1388,共5页
Chinese Journal of Family Planning
