作　　者： (田仁霞）; (韩国庆）; (李鸿儒）; (孙琴）; (陈莉）; (姚兵）; (梁元姣）;

机构地区： 南京大学医学院临床学院/南京总医院生殖医学中心

出　　处： 《中华临床医师杂志（电子版）》 2017年第10期1738-1743,共6页

摘　　要： 目的探讨在体外受精(IVF)/卵母细胞胞浆内单精子显微注射(ICSI)-胚胎移植(ET)中,垂体降调节后血清卵泡刺激素(FSH)水平的动态变化与获卵数的相关性。方法回顾性分析我中心使用促性腺激素释放激素激动剂(Gn RH-a)对垂体进行降调节超促排卵的751个IVF/ICSI-ET周期。促性腺激素(Gn)启动日及人绒毛促性腺激素(HCG)日测血清FSH水平,并计算HCG日与Gn启动日的FSH的差值,应用Pearson相关分析法分析Gn启动日FSH及HCG日FSH值与Gn日FSH差值与获卵数、成熟卵泡数的相关性,根据Gn日FSH水平分两组:FSH<4 m IU/L组和FSH≥4 m IU/L组。按HCG日与Gn启动日FSH差值分4组,分别为A组:差值<0;B组:0≤差值<10 m IU/ml;C组:10 m IU/ml≤差值<20 m IU/ml;D组:差值≥20 m IU/ml。用t检验比较组间Gn天数、Gn总用量、获卵数、成熟卵泡数的情况。结果 (1)Gn启动日FSH值与获卵数、成熟卵子数呈显著性负相关,r值分别为-0.307、-0.301(P<0.05),HCG日FSH值与Gn日FSH值的差值与获卵数、成熟卵子数呈显著性负相关,r值分别为-0.166、-0.179(P<0.05);(2)FSH≥4 m IU/ml组的获卵数[(11.93±4.13)枚]及成熟卵子数[(10.01±3.93)枚]比FSH<4 m IU/ml组[分别为(13.55±3.81)枚、(11.45±3.75)枚]显著性少,(3)根据HCG日FSH值与Gn日FSH值的差值分组,4组获卵数分别为(8.67±2.87)枚、(13.12±3.90)枚、(12.36±4.20)枚及(10.23±3.90)枚,其中A组获卵数最低,与其他三组相比差异有统计学意义(P<0.05),B组获卵数、成熟卵子数与其C、D组相比显著性增加。结论 Gn启动日FSH值及HCG日FSH与Gn日FSH的差值和获卵数呈负相关,其中Gn启动日的FSH水平与获卵数相关性更高。 Objective To investigate the correlation of the variation of serum FSH with the number of retrieved oocytes after pituitary down-regulation in IVF/ICSI-ET. Methods The data of patients undergoing pituitary down-regulation by using gonadotropin releasing hormone agonist(Gn RHa) in total 751 IVF/ICSI-ET cycles were retrospectively analyzed. The levels of FSH in serum on the day beginning of gonadotropin(Gn) and the day administration of human chorionic gonadotropin(HCG) were detected. The correlation of the FSH level with the oocyte number retrieved, and between the day HCG administration FSH values and the FSH of the day beginning of Gn difference with the total number of retrieved oocytes were analyzed. All cycles were divided into two groups according to the FSH level: FSH<4 m IU/ml group and FSH≥4 m IU/ml group. And four groups according to the difference of FSH the day of HCG administration and the day beginning of gonadotropin; the difference<0 group, 0≤the difference<10 m IU/ml group, 10 m IU/ml≤the difference<20 m IU/ml group, the difference≥20 m IU/ml group. The days of giving gonadotropin, the dose of gonadotropin, the total number of retrieved oocytes, the total number of mature oocytes were compared among the groups. Results(1) The FSH level of the day of beginning gonadotropin were negatively correlated to the total number of retrieved oocytes and the total number of mature oocytes(r=-0.307 and r=-0.301, respectively); the difference were negatively correlated to the total number of retrieved oocytes and the total number of mature oocytes(r=-0.166 and r=-0.179, respectively).(2) In FSH≥4 m IU/ml group, the total number of retrieved oocytes(11.93±4.13), the total number of mature oocytes(10.01±3.93) were significantly less than that in FSH<4 m IU/ml group(13.55±3.81, 11.45±3.75 respectively).(3) In the four groups, the total number of retrieved oocytes was 8.67±2.87, 13.12±3.90, 12.36±4.20 and 10.23±3.90 respectively. In A group, the total number of retrieved oocytes was significantly

关 键 词： 垂体降调节 控制性促排卵 卵泡刺激素 获卵数