Haadsma M L, Groen H, Fidler V, Seinen L H M, Broekmans F J M, Heineman M J, Hoek A
Department of Obstetrics and Gynaecology, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands.
Hum Reprod. 2009 Mar;24(3):546-52. doi: 10.1093/humrep/den384. Epub 2008 Dec 4.
The increase in miscarriage rate with female age is attributed to a decline in oocyte quality. This age-related decrease of oocyte quality is accompanied by a decrease in oocyte quantity. Assessment of the number of oocytes by ovarian reserve tests (ORTs) may therefore also represent their quality. The objective of our study was to assess the predictive value of ORTs for miscarriage in subfertile women.
This study was a subanalysis within a prospective cohort study of 474 subfertile ovulatory couples in two hospitals in Groningen, The Netherlands. The ORTs performed were: antral follicle count (AFC), basal and stimulated levels of follicle-stimulating hormone (FSH) and inhibin B, and the clomiphene citrate challenge test (CCCT). Women who achieved an ongoing pregnancy (n = 233) were compared with women experiencing miscarriage (n = 72) on the results of their ORTs and patient characteristics.
In univariate analysis, the outcome of the ORTs did not differ between the groups. Logistic regression analysis including patient characteristics such as female age did not reveal an association between the ORT results and miscarriage either.
Neither AFC, basal and stimulated levels of FSH and inhibin B, nor the CCCT have a statistically significant predictive value for miscarriage in subfertile ovulatory women.
女性流产率随年龄增长而升高，这归因于卵母细胞质量下降。与年龄相关的卵母细胞质量下降伴随着卵母细胞数量减少。因此，通过卵巢储备功能检测（ORT）评估卵母细胞数量也可能反映其质量。我们研究的目的是评估ORT对不育女性流产的预测价值。
本研究是在荷兰格罗宁根市两家医院对474对不育排卵夫妇进行的前瞻性队列研究中的一项亚分析。所进行的ORT包括：窦卵泡计数（AFC）、卵泡刺激素（FSH）和抑制素B的基础水平及刺激后水平，以及克罗米芬柠檬酸盐激发试验（CCCT）。根据ORT结果和患者特征，将成功持续妊娠的女性（n = 233）与流产女性（n = 72）进行比较。
在单因素分析中，两组间ORT结果无差异。纳入女性年龄等患者特征的逻辑回归分析也未显示ORT结果与流产之间存在关联。
对于不育排卵女性，AFC、FSH和抑制素B的基础水平及刺激后水平，以及CCCT对流产均无统计学显著的预测价值。
