| Objective：in vitro fertilization-embryo transfer(IVF-ET) assisted reproduction treatmentprocess, by comparing the different age groups, gestation and the pregnancy group and ovarianresponse between normal group and the reaction of bad patient’s age, basic level of estradiol(E2),follicle-stimulating hormone(FSH), follicle-stimulating hormone and luteinizing hormone(FSH/LH) and foundation of inhibinB(INHB)levels, basic sinus follicle number(AFC),gonadotrophin(designed.the Gn) and stimulation time, discuss the super ovulation(COH) controlin the process of the indicators of ovarian reserve function and the ability to predict IVF outcome,ultimately choose one or several reliable predictor used in clinical, guiding the super stimulateovulation scheme selection, in order to improve the success rate of IVF-ET.Methods：between January2011and December2011,218cases in the center of the I acceptduring IVF-ET help pregnant infertility patients were analyzed retrospectively.(mean age34.62±5.21)years of age, fixed number of year average of infertility(5.83±3.67)years, eliminatepolycystic ovary disease, ovarian surgery, the pituitary gland and other endocrine diseases.Select reason for tubal infertility, male factors, ovulation disorders, endometriosis and forunknown reasons, all of the patients were first IVF-ET assisted reproduction treatment. Stimulateovulation scheme selection of pituitary drop to adjust short plan and long plan, determine thestarting dose of designed.the Gn, according to patients age26~35,225U/d,36~45,300U/d.Within4days after drug monitoring ovarian follicle development situation, depending on thefollicle growth situation adjust the dosage. Patients before entering the IVF-ET cycle for a month,in the extraction of venous blood menses is2~4days, by the method of Enzyme LinkedImmunosorbent Assay(ELISA) to detect serum FSH, LH, E2and INHB level. Blood on the sameday, Voluson730color ultrasonic diagnostic instrument6.5MHz vaginal probe, transvaginalmonitoring bilateral ovaries number of sinus follicle diameter5mm or less.Results：1.Basic FSH, E2, FSH/LH, the number of eggs, designed.the Gn INHB, AFC, dosage andthe number of days,26~30years old group and31~35years old the difference between all theindexes had no statistical significance (P>0.05);36~40years old group compared with41to45years old group, the difference was statistically significant (P<0.05);26~30and31~35years oldgroup compared with36~40years old group, there was no statistically significant difference except the E2values (P>0.05), the other the difference had statistical significance (P<0.05);26~30and31~35years old group compared with41to45years old between group, thedifference was statistically significant (P<0.05).2.Ovarian response normal group and the comparison between the various indicators ofpoor ovarian response group, age, basic FSH, FSH/LH, INHB, AFC, designed.the Gn ofconsumption, stimulate the number of days of differences between the two groups wasstatistically significant (P<0.01); Serum E2values there was no statistically significant differencebetween the two groups (P>0.05), and poor ovarian response based INHB level, an AFC groupwas significantly lower than normal response group, patients’ age, foundation, FSH/LH, FSHlevel designed.the Gn dosage is higher than normal response group.3.Age, basic FSH, FSH/LH, INHB, the dosage of the sinus follicle number and designed.theGn and stimulate the number of days between pregnancy and pregnancy group, the differencewas statistically significant (P<0.01); Base E2value there was no statistically significantdifference between the two groups (P>0.05), the basic INHB, AFC pregnancy group wasobviously higher than that of no pregnancy group, and on the basis of the age, the amount ofFSH, FSH/LH and designed.the Gn, exciting days was lower than that in group withoutpregnancy.4.Single factor predicting ovarian response OR value in basic FSH, INHB, AFC andFSH/LH of E2, age, all have statistical significance,(P<0.05). Basis of AFC is on ovarian reservefunction prediction of INHB level and the reliable index independently. Using multiariableLogistic stepwise regression analysis, a number of eggs is increased with FSH/LH ratio andINHB level declined and regular), FSH/LH ratio and INHB level for egg number can bepredicted; Stepwise regression analysis showed no variables into the regression equation. Showthat age, basic FSH, E2, FSH/LH, INHB affect IVF-ET ending, but not on the prediction of IVFoutcome; No indicators can be individually in IVF-ET end make predictions.Conclusion:1. As the increase of age, ovarian reserve function gradually decline, older than35years oldwho attains the egg rate and pregnancy rate is significantly reduced, older than35years old isdefine the index of the ovarian reserve function decline. But the ovarian reserve function of theindividual difference is very big, age not as an independent predictor of ovarian reserve function. 2. Basic INHB level and AFC is an independent predictor of ovarian response best, basicINHB level and FSH/LH ratio for egg number can be predicted.3. E2values increased with the increase of age, but no obvious changes in the age of40,more than40years old increased obviously.4. Age, basic FSH, E2, FSH/LH, INHB in IVF-ET ending all have influence, but not on theprediction of IVF outcome... |
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