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目的探讨基础卵泡刺激素(bFSH)和基础黄体生成激素(bLH)比值对不孕患者行体外受精/卵胞浆内单精子注射-胚胎移植(IVF/ICSI-ET)时临床结局的预测价值。方法回顾分析2008年1月1日至2008年12月31日在本生殖中心因输卵管阻塞、子宫内膜异位症、男方少弱精子和无精子症、不明原因不育等行IVF/ICSI-ET年龄≤40岁的超排患者2,167例(2,167周期)。按bFSH值分为bFSH正常组(bFSH≤8.5 IU/L)及升高组(bFSH>8.5 IU/L);再按年龄分为≤29岁,30～34岁及35～40岁组。分析基础FSH/LH值在bFSH正常及升高两组不同年龄阶段患者在促性腺激素(Gn)刺激时间、Gn用量、获卵数及优质胚胎率,临床妊娠率、流产率、重度卵巢过度刺激综合征(OHSS)发生率的差异。结果 Gn用量在年龄≤29岁患者无论bFSH水平是否升高,基础FSH/LH≤1者明显少于>1者;获卵数在bFSH正常组患者中各年龄段基础FSH/LH≤1者明显多于>1者,且在年龄<35岁以前各组间随着基础FSH/LH升高获卵数明显减少;在bFSH升高组(bFSH>8.5 IU/L)患者中仅年龄30～34岁的患者基础FSH/LH≤1者获卵数明显多于>1者,在其余各组随FSH/LH升高获卵数均有减少趋势;Gn刺激时间、优质胚胎率、临床妊娠率、流产率在bFSH正常及升高组各年龄段均无统计学意义。结论基础FSH/LH值对指导选择合适的促排方案及Gn启动剂量有一定的指导意义。但不能仅凭借基础FSH/LH值预测IVF/ICSI临床结局。
Objective To investigate the predictive value of basal follicle stimulating hormone (bFSH) and basal body luteinizing hormone (bLH) ratio in predicting clinical outcome of infertile patients undergoing in vitro fertilization / intracytoplasmic sperm injection / embryo transfer (IVF / ICSI-ET). Methods A retrospective analysis was performed on IVF / ICSI-IVF in our reproductive center from January 1, 2008 to December 31, 2008 due to tubal occlusion, endometriosis, male oligozoospermia and azoospermia, unexplained infertility, 2,167 patients (2,167 cycles) with superovulation ET aged ≤40 years. According to the bFSH value, the patients were divided into normal bFSH group (bFSH≤8.5 IU / L) and elevated group (bFSH> 8.5 IU / L) .According to the age, they were divided into groups of≤29, 30 to 34 and 35 to 40 years old. Analysis of the basal FSH / LH values in patients with normal and elevated bFSH in two groups of different age groups in the gonadotrophin (Gn) stimulation time, Gn dosage, number of oocytes and quality embryo, clinical pregnancy rate, abortion rate, severe ovarian hyperstimulation Differences in the incidence of syndromes (OHSS). Results The dosage of Gn was significantly lower than 1 in patients with FSH / LH≤1 regardless of the increase of bFSH level in patients ≤29 years of age. The number of oocytes retrieved was significantly higher in FSH / LH≤1 among all the patients with normal bFSH More than 1, and the number of oocytes was significantly decreased with the increase of basal FSH / LH before the age of <35; in the group with elevated bFSH (bFSH> 8.5 IU / L), only the age of 30 to 34 The number of oocytes in the aged patients with basal FSH / LH≤1 was significantly higher than that in> 1, and the number of oocytes in the other groups decreased with increasing FSH / LH; Gn stimulation time, quality embryo rate, clinical pregnancy rate, Abortion rate in bFSH normal and elevated group of all age groups were not statistically significant. Conclusions The basic FSH / LH values have some guiding significance in guiding the choice of appropriate schedule of promoting blood flow and dose of Gn. However, IVF / ICSI clinical outcomes can not be predicted solely on the basis of baseline FSH / LH values.