本文選題：IVF-ET + AMH��； 參考：《南昌大學(xué)》2017年碩士論文

【摘要】：目的:評估AMH在改良早卵泡期超長方案、長方案中對卵巢反應(yīng)性的預(yù)測價(jià)值及AMH預(yù)測卵巢低反應(yīng)、高反應(yīng)的最佳臨界值。方法:回顧性分析130例行IVF/ICSI-ET助孕的女性,按COH方案分為改良早卵泡期超長方案組(A組,n=63)及長方案組(B組,n=67),比較兩組患者的臨床結(jié)局;分析AMH與年齡、AFC、基礎(chǔ)FSH、基礎(chǔ)LH、基礎(chǔ)E2、基礎(chǔ)T、Gn天數(shù)、Gn總量、hCG日LH、E2、P、獲卵數(shù)、受精率、優(yōu)胚數(shù)、優(yōu)胚率的相關(guān)關(guān)系;以獲卵數(shù)≤5個(gè)定義為低反應(yīng),獲卵數(shù)≥19個(gè)定義為高反應(yīng),評估AMH對卵巢低反應(yīng)、高反應(yīng)的預(yù)測價(jià)值;以妊娠結(jié)局分組,分析AMH對妊娠結(jié)局的預(yù)測價(jià)值。結(jié)果:1.改良早卵泡期超長方案組與長方案組患者Gn天數(shù)、Gn總量、hCG日LH、hCG日E2、hCG日P、hCG日內(nèi)膜(Em)、獲卵數(shù)、受精率、優(yōu)胚率、種植率、妊娠率之間差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。2. AMH與年齡、基礎(chǔ)FSH負(fù)相關(guān);與AFC、基礎(chǔ)LH、基礎(chǔ)T正相關(guān);AMH與Gn總量負(fù)相關(guān);與hCG日E2、獲卵數(shù)、優(yōu)胚數(shù)正相關(guān);與基礎(chǔ)E2、Gn天數(shù)、hCG日LH、P、受精率、優(yōu)胚率無相關(guān)關(guān)系。3.AMH預(yù)測卵巢低反應(yīng)的ROC曲線下面積為0.850,優(yōu)于AFC及FSH,當(dāng)AMH閾值為1.89 ng/ml時(shí),預(yù)測卵巢低反應(yīng)的靈敏度為90%,特異度為79%;AMH預(yù)測卵巢高反應(yīng)的價(jià)值最高,AUC=0.796,優(yōu)于AFC及FSH,當(dāng)AMH閾值為3.51ng/ml時(shí),預(yù)測卵巢高反應(yīng)的靈敏度為70%,特異度為77.5%。AMH預(yù)測卵巢低反應(yīng)、高反應(yīng)與COH方案無關(guān)。4.妊娠組年齡小于未妊娠組,優(yōu)胚率高于未妊娠組。5.AMH預(yù)測臨床妊娠價(jià)值不大。結(jié)論:1.改良早卵泡期超長方案組與長方案組臨床結(jié)局無明顯差別。2.在改良早卵泡期超長方案與長方案中,AMH是預(yù)測卵巢反應(yīng)性的可靠指標(biāo),但AMH不能預(yù)測妊娠結(jié)局。3.AMH在預(yù)測卵巢反應(yīng)性時(shí)優(yōu)于AFC、基礎(chǔ)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，

本文編號(hào)：1883240