Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, USA.
Reprod Sci. 2013 May;20(5):549-56. doi: 10.1177/1933719112459226. Epub 2012 Nov 20.
High serum follicle-stimulating hormone (FSH) levels have been associated with diminished ovarian reserve; however, the association between high urinary FSH and reduced natural fertility has yet to be established. We sought to characterize the relationship between a single or multiple measurements of early follicular phase urinary FSH and fertility. Women (n = 209), 30 to 44 years old with no history of infertility, who had been trying to conceive for less than 3 months, provided early follicular phase urine. Participants subsequently kept a diary to record bleeding and intercourse and conducted standardized pregnancy testing for up to 6 months. A subset of women (N = 95) collected urine on cycle day 3 for up to 6 cycles. Urine was analyzed for FSH and creatinine (cr) corrected. Proportional hazard models were used to calculate fecundability ratios (FRs). Urinary FSH levels across cycles from the same woman were highly correlated (adjusted intraclass correlation = .77); within-woman variance was 3-fold lower than variance among women. Women with an initial urinary FSH level <7 mIU/mg cr exhibited a nonsignificant reduction in the probability of pregnancy (adjusted FR 0.71, 95% confidence interval [CI]: 0.45-1.13), as did women with elevated urinary FSH (≥12 mIU/mg cr; adjusted FR 0.78, 95% CI: 0.46-1.32). Using the most recent or maximum urinary FSH value did not strengthen the association. In the general population, urinary FSH levels appear to be nonlinearly associated with fertility; however, broad CIs indicate a lack of statistical significance. Repetitive testing appears to be of little benefit.
血清卵泡刺激素（FSH）水平升高与卵巢储备功能降低有关；然而，高尿 FSH 与自然生育力降低之间的关系尚未确定。我们试图描述单个或多个卵泡早期阶段尿 FSH 测量值与生育力之间的关系。年龄在 30 至 44 岁之间、无不孕病史、尝试怀孕时间不足 3 个月的女性（n = 209）提供了卵泡早期阶段的尿液。参与者随后记录了出血和性交情况，并进行了长达 6 个月的标准化妊娠测试。一部分女性（n = 95）在周期第 3 天收集了尿液，持续了 6 个周期。尿液分析 FSH 和肌酐（cr）校正。比例风险模型用于计算生育力比值（FR）。同一女性的跨周期尿 FSH 水平高度相关（调整后的组内相关系数=.77）；个体内方差比个体间方差低 3 倍。初始尿 FSH 水平<7 mIU/mg cr 的女性妊娠概率略有降低（调整后的 FR 0.71，95%置信区间[CI]：0.45-1.13），尿 FSH 升高（≥12 mIU/mg cr 的女性也是如此；调整后的 FR 0.78，95%CI：0.46-1.32）。使用最近或最大的尿 FSH 值并不能增强这种关联。在一般人群中，尿 FSH 水平似乎与生育力呈非线性相关；然而，广泛的 CI 表明缺乏统计学意义。重复测试似乎没有什么好处。
