FSH水平及年龄预测卵巢功能降低患者ART助孕价值研究

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目的:探讨基础促卵泡激素(FSH)水平及年龄,在预测卵巢储备功能降低(DOR)患者辅助生殖技术(ART)助孕妊娠结局中的价值。方法:选择接受ART助孕DOR患者135例,根据年龄(以35岁为界)及基础FSH水平(以10mU/ml为界)分为4组:<35岁且FSH<10mU/ml组(A组)64例,<35岁且FSH≥10mU/ml组(B组)17例,≥35岁且FSH<10mU/ml组(C组)31例和≥35岁且FSH≥10mU/ml组(D组)23例。所有入选病例均采用体外受精(IVF)/卵胞浆内单精子注射(ICSI)周期拮抗药超促排卵方案助孕。比较各组所需促性腺激素(Gn)总量、Gn用药时间、取卵数、受精卵数、胚胎形成数、Ⅰ级胚胎百分比、周期取消率及妊娠率。结果:B组和D组Gn总量均非常显著高于A组和C组(P<0.01);B组与D组及A组与C组比较,均差异不显著(P>0.05)。各组间Gn用药时间比较,均差异不显著(P>0.05)。A组取卵数、受精卵数及胚胎形成数均最高,非常显著高于C组和D组(P<0.01);C组次之,非常显著高于B组和D组(P<0.01);B组与D组比较,差异不显著(P>0.05)。各组间Ⅰ级胚胎百分比比较,均差异不显著(P>0.05)。B组周期取消率最高,D组次之,均非常显著高于A组和C组(P<0.01)。A组妊娠率最高,显著高于C组和D组(P<0.05);B组次之,显著高于D组(P<0.05);A组与B组比较,差异不显著(P>0.05)。结论:基础FSH水平及年龄在预测DOR患者ART助孕妊娠结局中具有重要价值。 Objective: To investigate the value of basal follicle stimulating hormone (FSH) and its age in predicting the pregnancy outcome of assisted reproductive technology (ART) in patients with ovarian reserve loss (DOR). METHODS: One hundred and thirty-five patients with DOR were enrolled in this study. They were divided into 4 groups according to age (35 years old) and basal FSH level (10mU / ml): <35 years old and FSH <10mU / ml group (N = 17), 35 patients aged 35 years or older with FSH≥10 mU / ml (group B), 31 patients ≥35 years with FSH <10 mU / ml (group C) and 35 years or older with FSH≥10 mU / ml D group) 23 cases. All enrolled patients were assisted by IVF / ICSI cycles of antagonist over-ovulation. The total amount of gonadotropin (Gn), Gn administration time, number of oocytes retrieved, number of fertilized eggs, number of embryogenesis, percentage of grade Ⅰ embryos, cycle cancellation rate and pregnancy rate were compared among the groups. Results: The total amount of Gn in groups B and D were significantly higher than those in groups A and C (P <0.01). There was no significant difference between groups B and D and groups A and C (P> 0.05). There was no significant difference in Gn administration time among the groups (P> 0.05). In group A, the numbers of oocytes retrieved, the number of fertilized eggs and the number of embryos formed were the highest, which were significantly higher than those in groups C and D (P <0.01); those in group C were significantly higher than those in groups B and D (P <0.01) There was no significant difference between group B and group D (P> 0.05). There was no significant difference in the percentage of grade Ⅰ embryos between groups (P> 0.05). The cancellation rate was the highest in group B, followed by group D, which were significantly higher than those in group A and C (P <0.01). The pregnancy rate of group A was the highest, significantly higher than that of group C and group D (P <0.05), while group B was the second, which was significantly higher than that of group D (P <0.05). There was no significant difference between group A and group B ). Conclusion: The basal FSH level and age are of great value in predicting the pregnancy outcome of ART in DOR patients.
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