| 陈莉莎,赵莹莹,黄金娃,陈 月,于月新.血清25(OH)D、AMH和INHB联合检测在卵巢储备功能低下患者体外受精-胚胎移植妊娠结局中的应用价值[J].现代生物医学进展英文版,2022,(24):4795-4800. |
| 血清25(OH)D、AMH和INHB联合检测在卵巢储备功能低下患者体外受精-胚胎移植妊娠结局中的应用价值 |
| Application Value of Combined Detection of Serum 25(OH)D, AMH and INHB in Pregnancy Outcome of In Vitro Fertilization-Embryo Transfer in Patients with Diminished Ovarian Reserve |
| Received:May 21, 2022 Revised:June 17, 2022 |
| DOI：10.13241/j.cnki.pmb.2022.24.039 |
| 中文关键词: 卵巢储备功能低下 体外受精-胚胎移植 25(OH)D AMH INHB 妊娠结局 |
| 英文关键词: Diminished ovarian reserve In vitro fertilization-embryo transfer 25(OH)D AMH INHB Pregnancy outcome |
| 基金项目:军队计生专业科研课题项目（19JSZ12） |
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| 中文摘要: |
| 摘要 目的：血清25-羟维生素D[25(OH)D]、抗苗勒管激素（AMH）和抑制素B（INHB）联合检测在卵巢储备功能低下（DOR）患者体外受精-胚胎移植（IVR-ET）妊娠结局中的应用价值。方法：选择2019年8月~2021年10月我院行IVR-ET助孕的DOR患者292例，根据助孕后的妊娠结局分为妊娠组（n=158）和未妊娠组（n=134），比较两组临床资料及血清25(OH)D、AMH和INHB水平，应用受试者工作特征（ROC）曲线评价血清25(OH)D、AMH和INHB单独及联合检测对妊娠失败的预测价值。应用单因素、多因素Logisitic回归分析妊娠失败的影响因素。结果：妊娠组血清25(OH)D、AMH、INHB水平显著高于未妊娠组（P<0.05）。ROC曲线分析显示，血清25(OH)D、AMH、INHB及三者联合检验对DOR患者IVR-ET妊娠失败的预测的曲线下面积（AUC）分别为0.714（0.631~0.802）、0.801（0.731~0.852）、0.634（0.578~0.741）、0.853（0.806~0.913），三者联合检验对DOR患者IVR-ET妊娠失败预测AUC高于单独检验。单因素分析显示未妊娠组窦卵泡个数<5、获卵个数<8、卵泡刺激素（FSH）/黄体生成激素(LH)≥1.8、血清25(OH)D≤25.05 μg/L、血清AMH≤1.08 ng/mL、血清INHB≤84.28 pg/mL比例显著高于妊娠组（P<0.05）。多因素Logistic回归分析显示FSH/LH≥1.8、血清25(OH)D≤25.05 μg/L、血清AMH≤1.08 ng/mL、血清INHB≤84.28 pg/mL是DOR患者IVR-ET妊娠失败的危险因素（P＜0.05）。结论：血清25(OH)D、AMH和INHB 水平较低与DOR患者IVR-ET妊娠失败有关，且联合检测上述指标水平对患者IVR-ET妊娠失败有较高的辅助预测价值。 |
| 英文摘要: |
| ABSTRACT Objective: To evaluate the application value of serum 25-hydroxyvitamin D [25(OH)D], anti-Mullerian hormone (AMH) and inhibin B (INHB) in pregnancy outcome of in vitro fertilization-embryo transfer (IVR-ET) in patients with diminished ovarian reserve (DOR). Methods: 292 DOR patients who underwent IVR-ET assisted pregnancy in our hospital from August 2019 to October 2021 were selected, according to the pregnancy outcome after assisted pregnancy, they were divided into pregnancy group (n=158) and non-pregnancy group (n=134), the clinical data and the levels of serum 25(OH)D, AMH and INHB in the two groups were compared, the predictive value of serum 25(OH)D, AMH and INHB in separate and combination detection for pregnancy failure was evaluated by the receiver operating characteristic (ROC) curve. The influencing factors of pregnancy failure were analyzed by single factor analysis and multiple logistic regression. Results: The levels of serum 25(OH)D, AMH and INHB in pregnant group were significantly higher than those in non-pregnancy group (P<0.05). ROC curve analysis result showed that the area under the curve (AUC) of serum 25(OH)D, AMH, INHB and their combined detection in predicting IVR-ET pregnancy failure in patients with DOR were 0.714(0.631~0.802), 0.801(0.731~0.852), 0.634(0.578~0.741), 0.853(0.806~0.913) respectively, the AUC of the combined detection in predicting IVR-ET pregnancy failure in patients with DOR was higher than those in the separate detection. Single factor analysis results showed that the number of sinus follicles<5, the number of retrieved eggs<8, follicle stimulating hormone (FSH) / luteinizing hormone (LH)≥1.8, serum 25(OH)≤25.05 μg/L, serum AMH≤1.08 ng/mL, serum INHB≤84.28 pg/ml in the non-pregnancy group were significantly higher than those in pregnancy group (P<0.05). Multiple logistic regression analysis results showed that FSH/LH≥1.8, serum 25(OH)D≤25.05 μg/L, serum AMH≤1.08 ng/mL, serum INHB≤84.28 pg/mL were the risk factors of IVR-ET pregnancy failure in patients with DOR (P<0.05). Conclusion: The low levels of serum 25(OH)D, AMH and INHB are related to IVR-ET pregnancy failure in patients with DOR, and the combined detection of the above index levels has high auxiliary predictive value for IVR-ET pregnancy failure. |
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