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目的探讨基础卵泡刺激素(follicle stimulating hormone,b FSH)和黄体生成素(luteinizing hormone,LH)比值对不同年龄段的不孕患者行体外受精(in-vitro fertilization,IVF)/卵胞浆内单精子注射(intracytoplasmic sperm injection,ICSI)助孕结局的预测价值。方法回顾性分析2011年在成都市妇女儿童中心医院生殖中心因输卵管阻塞、男方少弱精子、不明原因不育等行IVF/ICSI-胚胎移植年龄≤40岁的超排患者381例(381周期)。按年龄分A、B、C 3组,A组:年龄≤30岁;B组:30<年龄<35岁;C组:年龄≥35岁。各组中再根据b FSH/LH分为两组,A 1组:FSH/LH<3,A 2组:FSH/LH≥3;B 1组:FSH/LH<3,B 2组:FSH/LH≥3;C 1组:FSH/LH<3,C 2组:FSH/LH≥3。比较各组患者在促性腺激素(gonadotropin,Gn)用量、获卵数、2 PN数、卵裂率、优质胚胎率、临床妊娠率的差异。结果 A、B、C组随着年龄增长,Gn用量逐渐增加,差异有统计学意义(P<0.05);A组与B、C组优胚数比较,差异有统计学意义(P<0.05);C组获卵数、2 PN数及卵裂数与A、B组比较,差异有统计学意义(P<0.05)。3组的妊娠率随年龄增长而降低,分别为:44.2%、43.0%、36.4%,但差异无统计学意义(P>0.05)。在B组中,随着b FSH/LH增加,获卵数、2 PN数、卵裂数降低,差异有统计学意义(P<0.05)。在C组中,随着b FSH/LH增加,2 PN数、卵裂数、优胚数降低,差异有统计学意义(P<0.05)。结论年龄结合b FSH/LH值可较好地评估卵巢储备功能及预测超促排卵中卵巢的反应性,对IVF临床治疗方案及Gn用药有指导意义,但仍需结合更多指标进行卵巢储备功能的评估。
Objective To investigate the effects of basal follicle stimulating hormone (b FSH) and luteinizing hormone (LH) ratio on in vitro fertilization (IVF) / intracytoplasmic single Predictive value of pregnancy outcome with intracytoplasmic sperm injection (ICSI). Methods A retrospective analysis of 381 cases (381 cycles) of superovulatory patients aged ≤40 years who undergone IVF / ICSI-embryo transfer at the Reproductive Center of Chengdu Women and Children’s Central Hospital in 2011 due to tubal obstruction, male oligozoospermia and unexplained infertility, . A, B, C groups by age, group A: age ≤30 years; group B: 30 0.05). In group B, as b FSH / LH increased, the number of oocytes retrieved, 2 PN, and number of cleavages decreased, with statistical significance (P <0.05). In group C, with the increase of b FSH / LH, the numbers of 2 PN, the number of cleavage and the number of excellent embryos decreased, with significant difference (P <0.05). Conclusions Age combined with b FSH / LH value can better evaluate ovarian reserve function and predict ovarian reactivity in hyperstimulation, which is of guiding significance for IVF clinical treatment and Gn medication. However, more indexes need to be combined for ovarian reserve evaluation of.