生殖医学杂志

目的探讨尿卵泡刺激素(FSH)、黄体生成素(LH)全定量测定在促性腺激素释放激素激动剂(GnHR-a)降调节后的应用价值。方法回顾性分析2012年10月至2013年4月在昆明医科大学第二附属医院生殖医学科接受长方案体外受精-胚胎移植(IVF-ET)和卵胞浆内单精子注射(ICSI)治疗的不孕症患者共208个周期,测定促性腺激素(Gn)启动日当天血清FSH、LH水平和尿FSH、LH全定量水平,分析两种测量方法的相关性以及血、尿FSH、LH与获卵数及妊娠结局的关系。血、尿FSH各分为三组(≤3 IU/L,>3⁵ IU/L,>5 IU/L),分析各组间年龄、获卵数、正常受精数、卵裂数、Gn使用总量、妊娠率等的差异。结果尿FSH与血FSH显著相关(r=0.508,P<0.01),尿LH与血LH相关(r=0.328,P<0.05)。通过Logistic回归分析,尿FSH各组间随尿FSH水平的升高,获卵数≤4枚的可能性增高1.95倍;将血FSH、LH、FSH/LH和尿FSH、LH、FSH/LH与卵巢反应性的关系进行Logistic回归分析,在逐步引入变量的过程中,只有尿FSH全定量水平与卵巢反应性有密切相关性。结论尿FSH、LH全定量水平与血清FSH、LH水平相关;尿FSH全定量可作为辅助判断降调节的指标并能预测卵巢的反应性。

Objective:To investigate the value of quantitative assay of urinary FSH and LH after GnRH agonist down-regulation during in vitro fertilization(IVF)or intracytoplasmic sperm injection(ICSI)cycles.Methods:The data of 208 cycles from the Second Affiliated Hospital of Kunming Medical University from October 2012 to April 2013 were retrospectively analyzed.The serum levels of FSH,LH and urinary FSH,LH were assayed on the gonadotropin starting day.All cycles were divided into three groups(≤3 IU/L,>3-5 IU/L,>5 IU/L)according to serum or urinary FSH levels.The number of retrieved oocytes,age,total gonadotropin dose,clinical pregnancy rate etc.among the three groups and the correlation between serum FSH,LH and urinary FSH,LH were analyzed.Results:The urinary FSH and LH levels was significantly correlated to the serum FSH(r=0.508,P<0.ODand LH(r= 0.328,P<0.05) levels.Statistically differences of serum levels of FSH and urinary FSH were found between the poor response cycles(number of mature oocytes ≤4) and the normal response cycles.By logistic regression analysis,a conclusion can be draw that the chance of occurring poor ovarian response raises 1.95 times with the increase of urinary FSH levels among different urinary FSH groups.Conclusions:The urinary FSH and LH levels were correlated to the serum FSH and LH levels.The quantitative urinary FSH could be used for predicting the ovarian response in IVF.