论文部分内容阅读
目的分析控制性超排卵第5日预测卵巢反应性生化指标的切值。方法回顾性分析2016年5-7月于该院生殖中心行体外受精-胚胎移植(IVF-ET)治疗的151个周期。控制性超排卵第5日检测卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E_2)及抗苗勒管激素(AMH),分析这些指标与获卵数的关系。结果控制年龄因素后,获卵数与控制性超排卵第5日AMH、E_2、E_2/FSH呈正相关;ROC曲线分析显示,预测卵巢低反应或卵巢高反应时ROC曲线下面积(AUC)>0.7的评价指标为控制性超排卵第5日AMH、E_2、E_2/FSH,其他各指标AUC<0.7;预测卵巢低反应性时,控制性超排卵第5日AMH最大AUC为0.779,临界值为1.57 ng/ml;预测卵巢高反应时,控制性超排卵第5日AMH最大AUC为0.772,临界值为8.15 ng/ml。结论 AMH、E_2及E_2/FSH均为长方案控制性超排卵启动后预测卵巢反应性较为准确的指标,可帮助临床医生判断是否取消周期,从而降低继续周期治疗所带来的医疗成本或风险。
Objective To analyze the cut-off value of predicting ovarian biochemical indexes on the 5th day of controlled ovarian hyperstimulation. Methods A retrospective analysis of 151 cycles of fertilization-embryo transfer (IVF-ET) in reproductive center from May to July in 2016 was conducted. Controlled superovulation on day 5, follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) and anti-Mullerian hormone (AMH) were measured. Results After controlling for age, the number of oocytes retrieved was positively correlated with the AMH, E_2 and E_2 / FSH on the 5th day of controlled ovarian hyperstimulation. The ROC curve showed that the area under the ROC curve (AUC) was> 0.7 for the prediction of ovarian low response or ovarian hypersensitivity The control index of AMH, E_2 and E_2 / FSH on the 5th day were AUC <0.7. When the ovarian hyporesponses were predicted, the maximum AUC of AMH on the 5th day of control superovulation was 0.779 and the critical value was 1.57 ng / ml. In the prediction of ovarian hyperstimulation, the maximum AUC of AMH on the 5th day of controlled ovarian hyperstimulation was 0.772 with a critical value of 8.15 ng / ml. Conclusions Both AMH, E_2 and E_2 / FSH are more accurate predictors of ovarian response after long-term regimen controlled superovulation and may help clinicians determine whether to cancel the cycle or not, thus reducing the medical costs or risks associated with continuing cycle treatment.