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目的:探讨基础总窦卵泡数(tAFC)在评价卵巢功能和预测ART结局中的作用。方法:回顾性分析1 353例接受常规体外受精(IVF)/卵母细胞质内单精子显微注射(ICSI)治疗的不孕患者早卵泡期窦卵泡计数的资料,按tAFC分组:A组<5个,B组5~10个,C组11~15个,D组>15个,分别统计各组促性腺激素(Gn)用量、hCG注射日直径≥14 mm卵泡数、获卵数、2原核(2PN)数、可利用胚胎数及妊娠结局。结果:tAFC对卵巢反应性和卵巢储备功能的预测价值优于年龄和基础卵泡刺激素(bFSH),tAFC<10个预示卵巢低反应性,>12个则预示卵巢高反应性;tAFC对ART结局的预测价值稍优于年龄和bFSH,tAFC>10个则预示临床妊娠可能性大,tAFC>15个或<5个则预示周期取消率增加。新鲜周期妊娠率随tAFC增多而上升(C组最高42.3%),周期取消率随tAFC增多而下降,但tAFC>15个时,周期取消率上升至24.2%,主要原因是卵巢过度刺激综合征(OHSS)。结论:基础tAFC与影响ART结局的各种因素密切相关,可作为预测ART结局的参考指标,并且直接有效地评价卵巢储备功能和卵巢反应性,是患者接受ART前的首选检查,临床应用中值得推广。
Objective: To investigate the role of basal antral follicle count (tAFC) in evaluating ovarian function and predicting the outcome of ART. Methods: A retrospective analysis of 1 353 cases of infertile patients receiving conventional in vitro fertilization (IVF) / intracytoplasmic sperm injection (ICSI) of antral follicular phase antral follicle count data were grouped by tAFC: group A <5 5 to 10 rats in group B, 11 to 15 rats in group C and 15 rats in group D, respectively. The amount of gonadotropin (Gn) in each group was calculated. The number of follicles with diameter≥14 mm on day of hCG injection, (2PN) number, the number of embryos available and the outcome of pregnancy. RESULTS: The predictive value of tAFC for ovarian response and ovarian reserve was superior to age and basal follicle stimulating hormone (bFSH), tAFC <10 predicts ovarian hyporesponseity, and> 12 predicts ovarian hyperreactivity. The effect of tAFC on ART outcome The predictive value was slightly better than the age and bFSH, tAFC> 10 indicates the possibility of clinical pregnancy, tAFC> 15 or <5 indicates the cycle cancellation rate increased. The rate of fresh cycle pregnancy increased with the increase of tAFC (up to 42.3% in group C), and the rate of cycle cancellation decreased with the increase of tAFC. However, when tAFC> 15, the cycle cancellation rate increased to 24.2%, mainly due to ovarian hyperstimulation syndrome OHSS). Conclusion: The basal tAFC is closely related to various factors influencing the outcome of ART and can be used as a reference index in predicting the outcome of ART. It also directly and effectively evaluates the ovarian reserve function and ovarian reactivity. It is the first choice of patients before ART, and is worthy of clinical application Promotion.