Creus M, Peñarrubia J, Fábregues F, Vidal E, Carmona F, Casamitjana R, Vanrell J A, Balasch J
Institut Clínic of Gynecology, Obstetrics and Neonatology, Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Hum Reprod. 2000 Nov;15(11):2341-6. doi: 10.1093/humrep/15.11.2341.
Recent reports investigating the value of basal inhibin B determination as a predictor of ovarian reserve and assisted reproduction treatment have led to discordant results. This study was undertaken to further assess the relative power of day 3 inhibin B and follicle stimulating hormone (FSH) (defined before treatment) and the woman's age both as single and combined predictors of ovarian response and pregnancy in an in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) programme. A total of 120 women undergoing their first cycle of IVF or ICSI was included. Forty consecutive cycles cancelled because of poor follicular response were initially selected. As a control group, the nearest completed IVF/ICSI cycles before and after each cancelled cycle (i.e. the closest cycles in temporal relationship to the index cycle) were used. Mean age and basal FSH concentrations were significantly higher in the cancelled than in the control group (P: < 0.01 and P: < 0.001 respectively), whereas basal inhibin B was significantly higher in the latter (P: < 0.05). The association of basal FSH (with an accuracy or predictive value of ovarian response of 79%) with cancellation rate was significant, independent of, and stronger than the effects of age and inhibin B (P: < 0.05). Any two or all three of these variables studied did not improve the predictive value of FSH alone. Woman's age was the only variable independently associated with pregnancy rate. It is concluded that the stronger predictors of success in patients undergoing their first IVF/ICSI treatment cycle are age and basal FSH rather than inhibin B. Basal FSH concentration was a better predictor of cancellation rate than age, but age was a stronger predictor of pregnancy rate.
近期有关基础抑制素B测定作为卵巢储备和辅助生殖治疗预测指标价值的研究报告结果并不一致。本研究旨在进一步评估第3天抑制素B和促卵泡激素（FSH）（治疗前定义）以及女性年龄作为体外受精（IVF）/卵胞浆内单精子注射（ICSI）方案中卵巢反应和妊娠的单一及联合预测指标的相对效力。总共纳入了120名接受首次IVF或ICSI周期治疗的女性。最初选择了40个因卵泡反应差而取消的连续周期。作为对照组，使用每个取消周期前后最近完成的IVF/ICSI周期（即与索引周期时间关系最接近的周期）。取消组的平均年龄和基础FSH浓度显著高于对照组（P值分别<0.01和<0.001），而后者的基础抑制素B显著更高（P值<0.05）。基础FSH与取消率的关联显著（卵巢反应的准确性或预测价值为79%），独立于年龄和抑制素B的影响且比其更强（P值<0.05）。所研究的这些变量中的任意两个或全部三个并未提高单独FSH的预测价值。女性年龄是唯一与妊娠率独立相关的变量。得出结论，在接受首次IVF/ICSI治疗周期的患者中，成功的更强预测指标是年龄和基础FSH而非抑制素B。基础FSH浓度比年龄更能预测取消率，但年龄对妊娠率的预测更强。
