| 潘长穿,陈文卫,赵世怡,徐望明.经阴道超声监测窦卵泡计数预测超排卵中卵巢低反应的价值[J].中国医学影像技术,2006,22(8):1236~1238 |
| 经阴道超声监测窦卵泡计数预测超排卵中卵巢低反应的价值 |
| Impact of antral follicle count on the prediction of poor ovarian response in women undergoing controlled ovarian hyperstimulation |
| 投稿时间：2006-03-22 修订日期：2006-07-29 |
| DOI： |
| 中文关键词: 经阴道超声 窦卵泡计数 超排卵 卵巢功能 |
| 英文关键词:Tansvaginal ultrasound Antral follicle count Controlled ovarian hyperstimulation Ovarian function |
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| 中文摘要: |
| 目的 探讨促性腺激素释放激素激动剂(GnRH-α)短方案超排卵治疗周期中,经阴道超声监测周期第2天窦卵泡计数(cycle day 2 antral follicle count,CD2-AFC)及治疗周期第6天的窦卵泡计数(cycle day 6 antral follicle count,CD6-AFC)对卵巢低反应的预测价值。方法 接受超排卵治疗的不孕症患者86例,年龄和基础FSH水平为我中心行IVF的正常范围。于治疗周期第2天和第6天行经阴道超声检查,测量CD2-AFC及CD6-AFC。并于当周期行GnRH-α短方案超排卵治疗,观察获卵数并根据获卵数判断卵巢反应性,分卵巢反应正常组和低反应组。结果 在匹配了年龄和bFSH水平后观察到:卵巢反应低下组CD2-AFC、CD6-AFC分别为(4.19±1.84)个和(6.47±1.50)个,均显著低于反应正常组的CD2-AFC、CD6-AFC 。据动态窦卵泡计数预测卵巢低反应的受试者工作特征曲线(ROC曲线)得出一个判断低反应的界值:CD2-AFC<5.5个和CD6-AFC<8.5个。CD6-AFC是一个比CD2-AFC更好的预测卵巢低反应的指标:CD6-AFC的ROC曲线下面积较CD2-AFC的大,CD6-AFC与获卵数的相关性较CD2-AFC的好。结论 经阴道超声动态监测CD2-AFC及CD6-AFC可提高GnRH-α短方案超排卵治疗患者卵巢低反应的预测率,CD6-AFC比CD2-AFC有更好的预测价值。动态窦卵泡计数有助于指导临床更合理的选择超排卵治疗用药及更早的取消无效超排卵治疗周期。 |
| 英文摘要: |
| Objective To study the values of cycle day 2 antral follicle count (CD2-AFC) and cycle day 6 antral follicle count (CD6-AFC) on the prediction of poor ovarian response in women with normal basal follicle-stimulating hormone levels in our center undergoing an IVF or ICSI cycle with GnRH-α analogue (a short protocol). Methods Eighty-six patients with an indication for IVF/ICSI were retrospectively analyzed. Women older than 35 years old or with a high (>8 IU/L) basal serum FSH level were not offered IVF/ICSI treatment in our study. During the IVF cycle, the number of cycle CD2 and CD6 follicles count were determined by transvaginal ultrasoud. Ovarian stimulation was commenced at day 3 with recombinant FSH. Ovarian response was evaluated according to the number of mature oocytes retrieved. Women were then divided into two groups with normal response and poor response. Results In the comparable group of poor responders, CD2-AFC, CD6-AFC were significantly lower than that of normal responders (P<0.05 and P<0.01). The cutoff values of CD2-AFC and CD6-AFC deduced by receiver operating characteristic curve were 5.5 and 8.5 respectively. CD6-AFC was better than CD2-AFC. Conclusion During a short IVF protocol, AFC is helpful in predicting ovarian response and CD6-AFC is better than CD2-AFC. This may help clinicians and women to cancel invalid cycles earlier and decrease the psychological, financial and medical burden of a later cancellation. |
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