Eldar-Geva T, Robertson D M, Cahir N, Groome N, Gabbe M P, Maclachlan V, Healy D L
Monash IVF, Department of Obstetrics and Gynecology, Monash University, Clayton, Victoria, Australia.
J Clin Endocrinol Metab. 2000 Feb;85(2):607-13. doi: 10.1210/jcem.85.2.6383.
The aim of this study was to investigate the relationship of serum inhibin A and inhibin B to ovarian follicular development in women undergoing pituitary down-regulation and ovarian stimulation with a fixed daily dose of recombinant human FSH in an in vitro fertilization program. Thirty-eight patients were treated randomly with either 100 or 200 IU/day recombinant human FSH (Puregon) for a period of 9-14 days. Serum FSH, inhibin A, inhibin B, 17beta-estradiol, and follicular size and number were determined before FSH treatment and every second day from days 4-6 throughout FSH treatment. Serum FSH increased in a dose-related manner to reach a maximum by days 4-6 and remained unchanged over the duration of treatment. Serum inhibin A and 17beta-estradiol also increased with increasing FSH dose and continued to rise throughout the FSH treatment period. By contrast, serum inhibin B was increased by days 4-6 at both doses of FSH to reach a maximum by days 7-8, remaining unchanged thereafter. Serum inhibin B and, to a lesser extent, inhibin A correlated significantly with the number of oocytes retrieved even when assessed early (days 4-6) in the treatment period (inhibin B vs. number of oocytes: r = 0.89; P < 0.001; inhibin A vs. number of oocytes: r = 0.61; P < 0.05). Serum inhibin A, inhibin B, and 17beta-estradiol were weakly correlated with the number of follicles less than 11 mm when assessed on a daily basis; stronger correlations were observed with the greater than 11-mm follicles during the late stages of treatment. It is concluded that serum inhibin B levels determined during the early stages (e.g. days 4-6) of fixed dose FSH treatment provide an early indicator of the number of recruited follicles that are destined to form mature oocytes. In this context, serum inhibin B may be of predictive value in monitoring ovarian hyperstimulation treatment for in vitro fertilization.
本研究旨在探讨在体外受精程序中，接受垂体降调节和固定日剂量重组人促卵泡激素（FSH）卵巢刺激的女性血清抑制素A和抑制素B与卵泡发育的关系。38例患者被随机给予100或200IU/天的重组人FSH（果纳芬）治疗9 - 14天。在FSH治疗前以及FSH治疗的第4 - 6天期间每隔一天测定血清FSH、抑制素A、抑制素B、17β - 雌二醇以及卵泡大小和数量。血清FSH呈剂量相关增加，在第4 - 6天达到最大值，并在治疗期间保持不变。血清抑制素A和17β - 雌二醇也随FSH剂量增加而升高，并在整个FSH治疗期持续上升。相比之下，两种剂量FSH时血清抑制素B在第4 - 6天升高，在第7 - 8天达到最大值，此后保持不变。即使在治疗早期（第4 - 6天）评估，血清抑制素B以及程度稍轻的抑制素A与回收的卵母细胞数量显著相关（抑制素B与卵母细胞数量：r = 0.89；P < 0.001；抑制素A与卵母细胞数量：r = 0.61；P < 0.05）。每日评估时，血清抑制素A、抑制素B和17β - 雌二醇与小于11mm的卵泡数量弱相关；在治疗后期与大于11mm的卵泡相关性更强。结论是，在固定剂量FSH治疗的早期阶段（如第4 - 6天）测定的血清抑制素B水平可作为注定形成成熟卵母细胞的募集卵泡数量的早期指标。在此背景下，血清抑制素B在监测体外受精的卵巢过度刺激治疗中可能具有预测价值。
