Miao Min-fang, Huang He-feng
Department of Gynecology Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China.
Zhonghua Fu Chan Ke Za Zhi. 2006 Feb;41(2):114-7.
To study prospectively the values of basal and dynamic measurement of inhibin B (INHB), estrodiol (E(2)) following gonadotrophin therapy in vitro fertilization (IVF) cycles in predicting ovarian response to stimulation in young women.
A total of 57 patients younger than 40 years of age undergoing their first cycle of long protocol IVF treatment were studied and serum INHB, E(2) levels were detected on day 3 of the menstrual cycle, before the first administration of gonadotrophin (day 0), on days 1 and 5 after gonadotrophin therapy (day 1, day 5). Ovarian response was presented by: number of oocytes/total rFSH dose and square root of (number of follicles/total rFSH dose). According to number of follicles, number of oocytes and presence or absence of ovarian hyperstimulation syndrome (OHSS), we categorized the results into three different groups: poor response, normal response and OHSS.
(1) Hormone levels on days 1, 5 of rFSH stimulation: There were positive correlation between INHB (r(S): 0.69 - 0.73), E(2) (r(S): 0.60 - 0.73) and ovarian response (P = 0.000). (2) INHB, and E(2) levels on day 5 of rFSH stimulation were significantly different between poor response, normal response and OHSS groups (P < 0.01), and INHB levels were 164.7, 696.2 and 1263.5 ng/L respectively, and estrodiol levels were 303.2, 1709.5 and 4261.0 pmol/L respectively.
Serum INHB, and E(2) levels shortly obtained after gonadotrophin therapy may offer an accurate and early prediction of ovarian response, and INHB response to ovarian stimulation may be a more sensitive and earlier index of ovarian response than estrodiol. Low serum INHB and E(2) levels may predict poor ovarian response; on the other hand, high serum INHB and E(2) levels may predict OHSS.
前瞻性研究年轻女性体外受精(IVF)周期中促性腺激素治疗后抑制素B(INHB)、雌二醇(E₂)的基础值和动态测量值在预测卵巢刺激反应方面的价值。
共研究了57例年龄小于40岁且首次接受长方案IVF治疗周期的患者,在月经周期第3天、首次注射促性腺激素前(第0天)、促性腺激素治疗后第1天和第5天(第1天、第5天)检测血清INHB、E₂水平。卵巢反应通过以下指标表示:卵母细胞数量/总重组促卵泡素(rFSH)剂量以及(卵泡数量/总rFSH剂量)的平方根。根据卵泡数量、卵母细胞数量以及是否存在卵巢过度刺激综合征(OHSS),将结果分为三个不同组:低反应组、正常反应组和OHSS组。
(1)rFSH刺激第1天、第5天的激素水平:INHB(r(S):0.69 - 0.73)、E₂(r(S):0.60 - 0.73)与卵巢反应之间存在正相关(P = 0.000)。(2)rFSH刺激第5天时,低反应组、正常反应组和OHSS组的INHB和E₂水平存在显著差异(P < 0.01),INHB水平分别为164.7、696.2和1263.5 ng/L,雌二醇水平分别为303.2、1709.5和4261.0 pmol/L。
促性腺激素治疗后短期内获得的血清INHB和E₂水平可准确、早期预测卵巢反应,且INHB对卵巢刺激的反应可能是比雌二醇更敏感、更早的卵巢反应指标。血清INHB和E₂水平低可能预示卵巢反应不良;另一方面,血清INHB和E₂水平高可能预示OHSS。