基础生殖激素和抑制素B水平在供精人工授精的临床价值
he clinical value of basal reproductive hormones and inhibin B in AID
目的：分析基础生殖激素和抑制素B水平与供精人工授精 （Artificial Insemination by Donor, AID）临床妊娠率间的关系，从而探讨其对AID临床结局的影响和可能预测价值。方法：对2009年～2011年1772对行AID治疗的夫妇临床资料进行回顾性分析，分析基础生殖激素（FSH、LH、E2、P、PRL和T）和抑制素B(Inhibin B,INHB)水平与AID临床妊娠率间的关系。结果：1772名妇女行AID治疗后有971名妇女获得临床妊娠（54.80%）。从分析基础生殖激素和INHB水平发现：①妊娠组基础FSH（7.02±1.93 mIU/ml）明显低于未妊娠组基础FSH(7.27±2.82 mIU/ml)（P < 0.05）；其中基础FSH≥15 mIU/ml组临床妊娠率明显低于基础FSH<15 mIU/ml (P <0.01)。②妊娠组基础INHB（90.61±73.37 ng/m）明显低于未妊娠组基础INHB(79.38±49.93 ng/ml)（P < 0.05）；其中基础INHB≥ 25 ng/ml的临床妊娠率明显高于基础INHB＜25 ng/ml (P <0.05)。③为了将卵巢储备功能与年龄的临床价值结合起来，本文应用FSH×年龄或 INHB/年龄来评价生育潜能。当FSH×年龄大于300时，妊娠率会明显下降，尤其是当其大于500时，妊娠率急剧下降(14.9%)。当INHB/年龄比值高于10时，妊娠率高达70.59%；当INHB/年龄降为1以下时，妊娠率明显下降至29.3%。⑤其中基础LH、E2、P、PRL和T 在妊娠与非妊娠组中没有区别。结论：实施AID对象中基础FSH值和基础INHB水平与AID临床妊娠率明显相关，可在一定程度上预测AID妇女的临床结局。如果将卵子质量与数量结合起来（如FSH×年龄，INHB/年龄）可以为不孕夫妇提供一个更好的临床评价指标。
IObjective The present study aims to explore the clinical significance of basal reproductive hormones and basal inhibin B in predicting the outcome of AID. Materials and methods A retrospective analysis was performed in 1772 patients undergoing AID, which is being conducted at a department of assisted reproduction from 2009 to 2011. The relationships between basal reproductive hormones (FSH, lutropin, estradiol, progesterone, prolactin and testost) or basal inhibin B and pregnancy rate in AID were assessed. Results: 971 women have access to clinical pregnancy (54.80%) in 1772 women undergoing AID treatment. Found from the analysis of basal reproductive hormones and basal inhibin B shows: ①Basal FSH average in the pregnancy group ( 7.02 ±1.93 mIU / ml) were significantly lower that that in the non-pregnant group (7.27 ± 2.82 mIU/ml); the women with basal FSH ≥ 15 mIU/ml have lower clinical pregnancy rate than those women with basal FSH<15 mIU/ml (P <0.01). ②Basal inhibin B in the pregnancy group (90.61 ± 73.37 ng/ml) were significantly higher than that in the non-pregnant group (79.38 ±49.93 ng / ml); when the basal INHB≥ 25 ng/ml, the clinical pregnancy rate was significantly higher than that with basal INHB ＜25 ng/ml (P <0.05).③To combine the clinical value of ovary reserve with age, FSH* age or inhibin B/ age was used to assess the pregnancy potential. When the level FSH* age climbed above 300, the pregnancy rate decreased significantly; especially when the level of FSH* age reached above 500, the pregnancy rate (14.9%) dropped remarkably. ④With the ratio of inhibin B/age rise, the pregnancy rate was increasing. When the ratio went up to 10, the pregnancy rate was 70.59%. When the ratio inhibin B/age went down to 1, the pregnancy rate(29.3%) decreased significantly. ⑤The basal lutropin, estradiol, progesterone, prolactin and testost have no difference between the pregnancy group and non-pregnant group. Conclusion The present study concludes that basal FSH and basal inhibin B have a close correction with clinical pregnancy rate of AID, which indicate they are biochemical markers for the prediction of outcome of AID. We believe that combine the egg quantity and quanlity (such as FSH*age and inhibin B/age) provides a better tool with which to counsel subfertile couples.
黄东晖、廖爱华、苏萍、胡廉
妇产科学基础医学临床医学
基础性激素FSHINHB年龄ID
basal reproductive hormonesFSHinhibin BageAID
黄东晖,廖爱华,苏萍,胡廉.基础生殖激素和抑制素B水平在供精人工授精的临床价值[EB/OL].(2013-03-07)[2025-06-19].http://www.paper.edu.cn/releasepaper/content/201303-205.点此复制
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