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第3天血清抑制素B可预测辅助生殖技术的结局。

Day 3 serum inhibin-B is predictive of assisted reproductive technologies outcome.

作者信息

Seifer D B, Lambert-Messerlian G, Hogan J W, Gardiner A C, Blazar A S, Berk C A

机构信息

Brown University School of Medicine, Providence, Rhode Island, USA.

出版信息

Fertil Steril. 1997 Jan;67(1):110-4. doi: 10.1016/s0015-0282(97)81865-1.

Abstract

OBJECTIVE

To determine if women with day 3 serum inhibin-B concentrations < 45 pg/mL (conversion factor to SI unit, 1.00) demonstrate a poorer response to ovulation induction and assisted reproductive technologies outcome relative to women with inhibin-B values > or = 45 pg/mL.

DESIGN

Analysis of inhibin-B, FSH, and E2 concentrations in day 3 serum samples.

SETTING

Academic clinical practice.

PATIENT(S): One hundred fifty-six women who underwent 178 assisted reproductive technology (ART) cycles with luteal phase GnRH agonist suppression plus hMG and urofollitropin stimulation.

MAIN OUTCOME MEASURE(S): Serum E2 on day of hCG, number of oocytes retrieved per patient, fertilization rate, cleavage rate, clinical pregnancy rate (PR) per initiated cycle, cancellation rate per initiated cycle, and spontaneous abortion rate.

RESULT(S): Women with day 3 serum inhibin-B < 45 pg/mL demonstrated 70% of the E2 response, had 66.6% of the number of oocytes retrieved per patient, with 28% of the clinical PR per initiated cycle, and three times the cancellation rate per initiated cycle than women with day 3 inhibin-B > or = 45 pg/mL. After controlling for age, day 3 serum FSH, day 3 serum E2, patient cycle number, and method of ART, day 3 serum inhibin-B > or = 45 pg/mL was noted to be prognostic of the number of oocytes retrieved and clinical PR. The adjusted odds ratio of clinical pregnancy for those with day 3 serum inhibin-B > or = 45 pg/mL versus those with inhibin-B < 45 pg/mL was 6.8 (95% confidence interval 1.8 to 25.6).

CONCLUSION(S): Women with low day 3 serum inhibin-B concentrations demonstrate a poorer response to ovulation induction and are less likely to conceive a clinical pregnancy through ART relative to women with high day 3 inhibin-B.

摘要

目的

确定月经周期第3天血清抑制素B浓度<45 pg/mL(转换为国际单位的换算因子为1.00)的女性相对于抑制素B值≥45 pg/mL的女性,在排卵诱导及辅助生殖技术结局方面是否反应较差。

设计

分析月经周期第3天血清样本中的抑制素B、促卵泡生成素(FSH)和雌二醇(E2)浓度。

设置

学术临床实践。

患者

156名女性,她们接受了178个辅助生殖技术(ART)周期,采用黄体期促性腺激素释放激素(GnRH)激动剂抑制加人绝经期促性腺激素(hMG)和尿促卵泡素刺激。

主要观察指标

注射人绒毛膜促性腺激素(hCG)当天的血清E2、每位患者获取的卵母细胞数量、受精率、卵裂率、每个启动周期的临床妊娠率(PR)、每个启动周期的取消率和自然流产率。

结果

月经周期第3天血清抑制素B<45 pg/mL的女性,其E2反应为抑制素B≥45 pg/mL女性的70%,每位患者获取的卵母细胞数量为66.6%,每个启动周期的临床PR为28%,每个启动周期的取消率是抑制素B≥45 pg/mL女性的3倍。在控制年龄、月经周期第3天血清FSH、月经周期第3天血清E2、患者周期数和ART方法后,发现月经周期第3天血清抑制素B≥45 pg/mL可预测获取的卵母细胞数量和临床PR。月经周期第3天血清抑制素B≥45 pg/mL者与抑制素B<45 pg/mL者相比,临床妊娠的校正比值比为6.8(95%置信区间1.8至25.6)。

结论

月经周期第3天血清抑制素B浓度低的女性对排卵诱导反应较差,相对于月经周期第3天抑制素B浓度高的女性,通过ART临床妊娠的可能性较小。

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