Watt A H, Legedza A T, Ginsburg E S, Barbieri R L, Clarke R N, Hornstein M D
Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
J Assist Reprod Genet. 2000 May;17(5):264-8. doi: 10.1023/a:1009458332567.
Basal follicle-stimulating hormone (FSH) and age are predictors of successful outcome in in vitro fertilization (IVF). More recently, the clomiphene citrate challenge test (CCCT) has been proposed as a better way to predict IVF outcome than FSH alone. The purpose of this study was to determine which indicator of ovarian reserve--basal (day 3) FSH or the CCCT--is the better predictor of IVF success in the critical age group of women over the age of 40.
In this retrospective study, basal FSH and clomiphene-stimulated FSH levels from 104 women who underwent 175 cycles of IVF were analyzed.
Neither basal FSH level nor stimulated FSH level alone were statistically significant predictors of IVF success; however, no patient with a day 3 FSH level > 11.1 mIU/ml or a stimulated day 10 FSH level > 13.5 mIU/ml conceived and carried a pregnancy. All ongoing pregnancies occurred in the first two cycles of IVF.
Clear prognostic cutoff values were found to predict IVF success in women over age 40. IVF programs should consider limiting the number of cycles of IVF in women above age 40.
基础促卵泡激素（FSH）和年龄是体外受精（IVF）成功结局的预测指标。最近，有人提出枸橼酸氯米芬激发试验（CCCT）比单独使用FSH能更好地预测IVF结局。本研究的目的是确定在40岁以上的关键年龄组女性中，哪个卵巢储备指标——基础（第3天）FSH还是CCCT——是IVF成功的更好预测指标。
在这项回顾性研究中，分析了104名接受175个IVF周期的女性的基础FSH和氯米芬刺激后的FSH水平。
基础FSH水平或单独的刺激后FSH水平均不是IVF成功的统计学显著预测指标；然而，第3天FSH水平>11.1 mIU/ml或第10天刺激后FSH水平>13.5 mIU/ml的患者均未受孕并成功妊娠。所有持续妊娠均发生在IVF的前两个周期。
发现了明确的预后临界值来预测40岁以上女性的IVF成功。IVF项目应考虑限制40岁以上女性的IVF周期数。
