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目的:探讨基础卵泡刺激素(bFSH)水平升高是否为排除体外受精-胚胎移植(IVF-ET)治疗的指标。方法:回顾性分析3 498个取卵周期,按年龄分3组(<35周岁、35～39周岁、≥40周岁),再以bFSH水平不同细分A组(FSH≤9.99 IU/L)、B组(FSH 10.00～14.99 IU/L)、C组(FSH 15.00～19.99 IU/L)和D组(FSH≥20.00 IU/L)4个亚组,比较获卵数、临床妊娠率等多项指标的差异。结果:年龄<35岁、35～39岁和年龄≥40岁3组中B组、C组和D组患者的基础窦状卵泡数和获卵数明显低于A组,Gn总量和周期取消率明显高于A组,而受精率和卵裂率无明显统计学意义。年龄<35岁者中,A组、B组、C组、D组的临床妊娠率分别为47.8%、40.0%、26.3%、31.6%(P<0.05),活产率分别为40.2%、31.5%、21.1%、31.6%(P<0.05);年龄35～39岁时,A组、B组、C组、D组的临床妊娠率分别为39.7%、31.1%、22.7%、23.1%(P>0.05),活产率分别是28.5%、20.4%、18.2%、15.4%(P>0.05);年龄≥40岁时,A组、B组、C组、D组的临床妊娠率分别是15.5%、5.3%、8.3%、0%(P>0.05),活产率分别是11.0%、2.6%、8.3%、0%(P>0.05)。结论:bFSH≥10 IU/L时,提示卵巢储备功能和卵巢反应性减低,需增大促排卵治疗的Gn剂量,对于<40岁的不孕妇女,其FSH10～20 IU/L亦能获得较好的临床妊娠率,但bFSH>20 IU/L,亦获得了临床妊娠,故bFSH升高并非排除IVF治疗的指标。
Objective: To investigate whether elevated basal follicle stimulating hormone (bFSH) is an indicator of excluding IVF-ET treatment. Methods: A total of 3 498 oocyte retrieval cycles were retrospectively analyzed. The patients were divided into three groups (<35 years old, 35-39 years old, 40 years old or older), and group A (FSH≤9.99 IU / L) A total of 4 subgroups including 4 groups (FSH 10.00 ~ 14.99 IU / L), C group (FSH 15.00-19.99 IU / L) and D group (FSH≥20.00 IU / L) Differences in indicators. Results: The number of basal antral follicles and the number of oocytes retrieved in group B, group C and group D were significantly lower than those in group A at age 35 years, 35-39 years and age 40 years old. The total amount of Gn and cycle cancellation The rate was significantly higher than that of group A, but the fertilization rate and cleavage rate had no statistical significance. The clinical pregnancy rates of group A, group B, group C and group D were 47.8%, 40.0%, 26.3% and 31.6% respectively (P <0.05), and the live birth rates were 40.2% and 31.5 %, 21.1% and 31.6%, respectively (P <0.05). The clinical pregnancy rates of group A, group B, group C and group D were 39.7%, 31.1%, 22.7% and 23.1% > 0.05) .The live birth rates were 28.5%, 20.4%, 18.2% and 15.4% respectively (P> 0.05). The clinical pregnancy rates of group A, B, C and D were 15.5 %, 5.3%, 8.3%, 0% (P> 0.05). The live birth rates were 11.0%, 2.6%, 8.3% and 0%, respectively. Conclusion: bFSH≥10 IU / L, suggesting ovarian reserve and ovarian response to reduce the need to increase the dose Gn ovulation induction therapy for 20 IU / L, also obtained clinical pregnancy, so the elevated bFSH is not excluded indicators of IVF treatment.