Fried Gabriel, Remaeus Katarina, Harlin Jonas, Krog Elisabeth, Csemiczky György, Aanesen Arthur, Tally Michael
Reproductive Medical Center, Department of Women and Child Health, Division of Obstetrics and Gynecology, Karolinska Hospital, S-171 76 Stockholm, Sweden.
J Assist Reprod Genet. 2003 May;20(5):167-76. doi: 10.1023/a:1023656225053.
To perform a retrospective analysis of 62 age-matched IVF-treated women in order to investigate whether levels of inhibin B, IGF-I, and IGFBP-1 in serum 2 days before oocyte retrieval and in follicular fluid at the day of oocyte retrieval might be useful as indicators of the ovarian ability to produce oocytes (ovarian reserve).
Patients were allocated into three groups on the basis of the number of oocytes retrieved. Group 1 ("low responders") had 0-3 oocytes, group 2 ("normal responders") had 6-11 oocytes, and group 3 ("high responders") had 12 oocytes or more. Levels of inhibin B, IGF-I, and IGFBP-1 in follicular fluid and in serum obtained 2 days before oocyte retrieval were analyzed and correlated to clinical parameters including estradiol levels, progesterone levels, follicle size, follicle number, and oocyte number.
We found significant differences in inhibin B levels in the three groups. Inhibin B levels in follicular fluid and serum was strongly correlated to the number of oocytes retrieved (p < 0.01). The number of oocytes retrieved were also correlated to total FSH dose (p < 0.05), to estradiol 2 days before and at ovum pick-up (p < 0.05), to progesterone at ovum pick-up (p < 0.0001), to progesterone at embryo transfer (p < 0.05), and to the number of follicles (size 12-15 mm, p < 0.001, size > 15 mm, p < 0.01). Serum inhibin B also correlated to follicular fluid inhibin B (p < 0.01). Inhibin B was not correlated to pregnancy. In contrast, the ratio IGF-I/IGFBP-1 in serum as well as in follicular fluid was significantly higher in women who became pregnant (p < 0.05).
The results show that inhibin B in serum 2 days before oocyte retrieval predicts number of oocytes retrieved. Since inhibin B in serum before oocyte retrieval in ovarian hyperstimulation was strongly predictive of the number of oocytes retrieved, it appears useful as a marker for ovarian response. Inhibin B did not predict treatment outcome, whereas the ratio IGF-I/IGFBP-1 in serum and follicular fluid was significantly higher in women who became pregnant. The ratio IGF-I/IGFBP-1 may thus reflect oocyte quality.
对62例年龄匹配的接受体外受精治疗的女性进行回顾性分析，以研究取卵前2天血清中抑制素B、胰岛素样生长因子-I（IGF-I）和胰岛素样生长因子结合蛋白-1（IGFBP-1）水平以及取卵日卵泡液中的这些水平是否可作为卵巢产生卵母细胞能力（卵巢储备）的指标。
根据取卵数量将患者分为三组。第1组（“低反应者”）有0 - 3个卵母细胞，第2组（“正常反应者”）有6 - 11个卵母细胞，第3组（“高反应者”）有12个或更多卵母细胞。分析取卵前2天获得的卵泡液和血清中抑制素B、IGF-I和IGFBP-1的水平，并将其与包括雌二醇水平、孕酮水平、卵泡大小、卵泡数量和卵母细胞数量在内的临床参数进行关联。
我们发现三组之间抑制素B水平存在显著差异。卵泡液和血清中的抑制素B水平与取卵数量密切相关（p < 0.01）。取卵数量还与总促卵泡激素（FSH）剂量（p < 0.05）、取卵前2天及取卵时的雌二醇水平（p < 0.05）、取卵时的孕酮水平（p < 0.0001）、胚胎移植时的孕酮水平（p < 0.05）以及卵泡数量（直径12 - 15毫米，p < 0.001；直径> 15毫米，p < 0.01）相关。血清抑制素B也与卵泡液抑制素B相关（p < 0.01）。抑制素B与妊娠无关。相反，怀孕女性血清和卵泡液中IGF-I/IGFBP-1的比值显著更高（p < 0.05）。
结果表明，取卵前2天血清中的抑制素B可预测取卵数量。由于卵巢过度刺激时取卵前血清中的抑制素B能强烈预测取卵数量，它似乎可作为卵巢反应的标志物。抑制素B不能预测治疗结果，而怀孕女性血清和卵泡液中IGF-I/IGFBP-1的比值显著更高。因此，IGF-I/IGFBP-1的比值可能反映卵母细胞质量。
