[窦卵泡数量与体外受精成功率：多变量分析]

da Silva Geisa Mara, Diniz Angélica Lemos Debs, Bernardino Neto Morun, Marcolini Túlio Tadeu, Perillo Luis Carlos Alves, Pires Waldely de Paula, Pessoa Sílvio Marques

Universidade Federal de Uberlândia - UFU, Uberlândia, MG, Brasil.

Departamento de Ginecologia e Obstetrícia, Universidade Federal de Uberlândia - UFU, Uberlândia, MG, Brasil.

Rev Bras Ginecol Obstet. 2014 Oct;36(10):473-9. Epub 2014 Sep 23.

PURPOSE

To determine whether the antral follicle count can predict the number of retrieved oocytes in patients undergoing in vitro fertilization (IVF) and to correlate it with maternal age and pregnancy rate.

METHODS

This was a retrospective observational study based on a review of medical records from 193 patients who underwent assisted reproduction techniques between September 2010 and September 2012 in a Clinic for Human Reproduction. The study included women indicated for IVF who had follicle-stimulating hormone levels below 10 mIU/mL on third day of the menstrual cycle, with oocyte recipients being excluded. The patients were divided into three groups according to the number of antral follicle (up to 10 follicles, 11-22 follicles, and 23 or more follicles). To compare these three groups with the group of patients who became pregnant, patients who had not developed oocytes and had not undergone embryo transfer were also excluded. Spearman's correlation coefficient was used to measure the level of association between the numerical variables, and χ2 test was used to compare pregnancy rates with antral follicle count. To assess the likelihood of pregnancy, we used multivariate logistic regression, with the level of significance set at 5%.

RESULTS

The pregnancy rate of the sample was 35.6%. There was a positive significant correlation (sc) between antral follicle count and number of retrieved oocytes (sc=0.5; p<0.05) and a negative correlation between antral follicle count and age (sc= -0.5; p<0.05). There was no significant difference (p=0.16) when groups with different numbers of follicles were compared to the positive pregnancy test group; however, a cutoff of 27 antral follicles was observed in multivariate analysis, after which the probability of successful gestation tended to remain constant.

CONCLUSIONS

The antral follicle count decreases over the years, is a predictor of the number of retrieved oocytes and can predict the likelihood of the success of in vitro fertilization.

目的

确定窦卵泡计数能否预测接受体外受精（IVF）患者的获卵数，并将其与产妇年龄和妊娠率相关联。

方法

这是一项回顾性观察研究，基于对2010年9月至2012年9月在一家人类生殖诊所接受辅助生殖技术的193例患者的病历审查。该研究纳入月经周期第3天促卵泡激素水平低于10 mIU/mL的IVF适应证女性，卵母细胞受者被排除。根据窦卵泡数量（最多10个卵泡、11 - 22个卵泡和23个或更多卵泡）将患者分为三组。为了将这三组与妊娠患者组进行比较，未发育出卵母细胞且未进行胚胎移植的患者也被排除。采用Spearman相关系数测量数值变量之间的关联程度，采用χ2检验比较妊娠率与窦卵泡计数。为评估妊娠可能性，我们使用多因素逻辑回归，显著性水平设定为5%。

结果

样本的妊娠率为35.6%。窦卵泡计数与获卵数之间存在显著正相关（sc = 0.5；p < 0.05），窦卵泡计数与年龄之间存在负相关（sc = -0.5；p < 0.05）。将不同卵泡数量组与妊娠试验阳性组进行比较时，差异无统计学意义（p = 0.16）；然而，在多因素分析中观察到窦卵泡数为27个的临界值，此后成功妊娠的概率趋于保持恒定。