卵泡刺激素-黄体生成素比值及体外受精-胚胎移植结局关系.doc

卵泡刺激素/黄体生成素比值及体外受精-胚胎移植结局关系 　 作者：林文琴，杨海燕，陈霞，林金菊，叶碧绿 【摘要】 目的：探讨体外受精-胚胎移植（in vitro fertilization-embryo transfer，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（lt;12.5 IU/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/LHlt;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 gt;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≥14 mm卵泡数、获卵数显著性高于B组（P lt;0.05）。Gn用量、周期取消率A组显著低于B组（P lt;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 Abstract: Objective: To evaluate the relationship between basal follicle stimulating hormone to luteinizing hormone (FSH/LH) ratio and the outcome of in vitro fertilization-embryo transfer(IVF-ET). Methods:148 patients with basal FSH level in nomal range（lt;12.5 IU/L） were studied prospectively. All patients received GnRH-a/ rFSH/ human chorionic gonadotrophin（hCG）protocol for IVF-ET treatment. According to the different basal FSH/LH ratio， they were divided into two groups:87 patients as group A(FSH/LHlt;2)， 61 patients as group B(FSH/LH≥2). Basal datas， ovarian response and the outcomes of IVF were compared between two groups. Results: There were no significant differences in age， basal FSH， fertility rate， the number of transferred embryos， implatation rate and clinical pregnancy rate between two groups (P gt;0.05). However，the basal LH level，the E2 level on the day of HCG， the number of follicles(≥14 mm) and the number of oocytes obtained in group A were significantly higher than that in group B， and the amount of gonadotropin (Gn) used， poor response rate were significantly lower than that in group B. Conclusion: Basal FSH/LH ratio≥2 reduces the ovarian response to Gn significantly. The Basal FSH/LH ratio may be a good predictor of ovarian response in infertile women with nomal basal FSH level. Key words: gonadotropin；in vitro fertilization；embryo transfer；pregnancy o