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目的探讨基础睾酮水平对卵巢储备功能下降(DOR)患者控制性超促排卵(COH)及体外受精/卵胞浆内单精子注射-胚胎移植(IVF/ICSI-ET)结局的预测作用。方法回顾性分析2010年1月~2013年8月于我院生殖中心应用Gn RH拮抗剂(Gn RH-ant)方案促排卵行IVF/ICSI助孕的DOR患者138例,探讨基础睾酮与COH各参数的相关性及对IVF妊娠结局的影响。结果 DOR患者妊娠组的基础睾酮水平、窦卵泡数、HCG日E2水平和获卵数显著高于未妊娠组(P<0.05);在相关分析中,体重指数、窦卵泡数及获卵数与基础睾酮水平呈正相关;ROC曲线显示,基础睾酮水平与DOR患者IVF妊娠结局存在相关性,曲线下面积为0.779(95%CI 0.704-0.855,P<0.01),基础睾酮的最佳界值为20.86ng/dl,敏感度81.8%,特异度61.9%。结论基础睾酮水平能较好地预测DOR患者IVF妊娠结局,当DOR患者基础T水平高于20.86ng/dl时临床妊娠率较高。
Objective To investigate the predictive value of basal testosterone on the outcome of controlled ovarian hyperstimulation (COH) and in vitro fertilization / intracytoplasmic sperm injection-embryo transfer (IVF / ICSI-ET) in patients with decreased ovarian reserve (DOR). Methods A retrospective analysis of 138 patients with DOR induced by IVF / ICSI with Gn RH antagonist (Gn RH-ant) regimen from January 2010 to August 2013 in our hospital was performed to investigate the relationship between basal testosterone and COH Correlation of Parameters and Impact on IVF Pregnancy Outcomes. Results The levels of basic testosterone, antral follicles, E2 level on HCG day and number of oocytes retrieved in pregnancy group were significantly higher than those in non-pregnant group (P <0.05). In the correlation analysis, body mass index, antral follicle count, ROC curve showed that there was a correlation between basal testosterone level and IVF pregnancy outcome in DOR patients. The area under the curve was 0.779 (95% CI 0.704-0.855, P <0.01), and the basal testosterone had the best cutoff value of 20.86 ng / dl, sensitivity 81.8%, specificity 61.9%. Conclusion The basal testosterone level can predict the outcome of IVF in DOR patients well. The clinical pregnancy rate is higher when the basal T level of DOR is higher than 20.86ng / dl.