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目的探讨年龄、卵巢体积、窦卵泡数(AFC)、基础雌二醇(b E2)、基础卵泡刺激素(b FSH)、基础卵泡刺激素/基础黄体生成素(b FSH/b LH)、抑制素B(INHB)、抗苗勒管激素(AMH)8项指标在预测卵巢储备功能的价值,为临床超排卵方案的选择提供一定依据。方法回顾性分析322例行体外受精/卵细胞内单精子注射-胚胎移植(IVF/ICSI-ET)患者的临床资料,使用Pearson’scorrelation进行相关性分析;应用受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评价各指标预测卵巢反应性的价值。结果:1年龄、b E2、b FSH、b FSH/b LH值与获卵数呈负相关,AMH、INHB、AFC与获卵数呈正相关,相关性均有统计学意义(P<0.05);并且相关性AMH>AFC>INHB>b FSH/b LH>年龄>b FSH>b E2;而卵巢体积与获卵数的相关性无统计学意义。2年龄、b FSH、b FSH/b LH、AMH、INH B、AFC预测卵巢低反应的ROC曲线下面积分别为0.687、0.643、0.815、0.947、0.825、0.867,均大于机会参考下面积(P<0.05),卵巢体积ROC曲线下面积小于机会参考下面积,b E2的ROC曲线下面积为0.577,但两者均没有统计学意义(P>0.05)。结论年龄、b FSH、b FSH/b LH、AMH、AFC、INHB能预测卵巢储备功能;其中,AMH对于卵巢储备功能的预测价值最高,AFC、INHB、FSH/LH、年龄、FSH依次降低,卵巢体积、b E2对卵巢储备功能的预测有限。
Objective To investigate the effects of age, ovarian volume, AFC, b E2, b FSH, b FSH / b LH, Eight indexes of INHB and AMH were used to predict the value of ovarian reserve function, which provided some evidences for the choice of clinical superovulation. Methods The clinical data of 322 patients undergoing in vitro fertilization / intracytoplasmic sperm injection / embryo transfer (IVF / ICSI-ET) were retrospectively analyzed. Pearson’s scale was used to analyze the correlation. The receiver operating characteristic (ROC) The area under the curve (AUC) was calculated to evaluate the value of each index in predicting ovarian response. Results: There was a negative correlation between the LH value of b E2, b FSH and FSH / b and the number of oocytes retrieved at 1 year of age. The AMH, INHB and AFC were positively correlated with the number of oocytes retrieved (P <0.05). And the correlation AMH> AFC> INHB> b FSH / b LH> age> b FSH> b E2; but ovarian volume and the number of oocytes retrieved was not statistically significant. The areas under the ROC curve of 2-age, b FSH, b FSH / b LH, AMH, INH B and AFC predicted ovarian hyporesponse were 0.687,0.643,0.815,0.947,0.825,0.867 respectively, which were all higher than the reference area under the reference of opportunity (P < 0.05). The area under the ROC curve of ovarian volume was less than the area under the reference of opportunity, and the area under the ROC curve of b E2 was 0.577, but both were not statistically significant (P> 0.05). Conclusions Age, b FSH, b FSH / b LH, AMH, AFC and INHB can predict ovarian reserve function. Among them, AMH has the highest predictive value for ovarian reserve, AFC, INHB, FSH / LH, Volume, b E2 has a limited prediction of ovarian reserve function.