抗苗勒管激素在改良早卵泡期超长方案与长方案中的应用的相关研究

发布时间：2018-05-13 12:57

  本文选题：IVF-ET + AMH　； 参考：《南昌大学》2017年硕士论文

【摘要】：目的:评估AMH在改良早卵泡期超长方案、长方案中对卵巢反应性的预测价值及AMH预测卵巢低反应、高反应的最佳临界值。方法:回顾性分析130例行IVF/ICSI-ET助孕的女性,按COH方案分为改良早卵泡期超长方案组(A组,n=63)及长方案组(B组,n=67),比较两组患者的临床结局;分析AMH与年龄、AFC、基础FSH、基础LH、基础E2、基础T、Gn天数、Gn总量、hCG日LH、E2、P、获卵数、受精率、优胚数、优胚率的相关关系;以获卵数≤5个定义为低反应,获卵数≥19个定义为高反应,评估AMH对卵巢低反应、高反应的预测价值;以妊娠结局分组,分析AMH对妊娠结局的预测价值。结果:1.改良早卵泡期超长方案组与长方案组患者Gn天数、Gn总量、hCG日LH、hCG日E2、hCG日P、hCG日内膜(Em)、获卵数、受精率、优胚率、种植率、妊娠率之间差异均无统计学意义(P0.05)。2. AMH与年龄、基础FSH负相关;与AFC、基础LH、基础T正相关;AMH与Gn总量负相关;与hCG日E2、获卵数、优胚数正相关;与基础E2、Gn天数、hCG日LH、P、受精率、优胚率无相关关系。3.AMH预测卵巢低反应的ROC曲线下面积为0.850,优于AFC及FSH,当AMH阈值为1.89 ng/ml时,预测卵巢低反应的灵敏度为90%,特异度为79%;AMH预测卵巢高反应的价值最高,AUC=0.796,优于AFC及FSH,当AMH阈值为3.51ng/ml时,预测卵巢高反应的灵敏度为70%,特异度为77.5%。AMH预测卵巢低反应、高反应与COH方案无关。4.妊娠组年龄小于未妊娠组,优胚率高于未妊娠组。5.AMH预测临床妊娠价值不大。结论:1.改良早卵泡期超长方案组与长方案组临床结局无明显差别。2.在改良早卵泡期超长方案与长方案中,AMH是预测卵巢反应性的可靠指标,但AMH不能预测妊娠结局。3.AMH在预测卵巢反应性时优于AFC、基础FSH。
[Abstract]:Aim: to evaluate the predictive value of AMH for ovarian reactivity in the modified early follicle stage super-long regimen and the optimal critical value of AMH for predicting ovarian hyporesponsiveness and hyperresponsiveness. Methods: a retrospective analysis was made on 130 women who received IVF/ICSI-ET for pregnancy. According to the COH regimen, they were divided into two groups: group A (group A) and group B (group B). The clinical outcomes of the two groups were compared. The correlation between AMH and AFS, basic FSH, basic LH2, basic E2, TGn total number of Gn per day, egg number, fertilization rate, optimal embryo number and embryo rate were analyzed, and the definition of egg number 鈮，

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