目的 探讨在体外授精(in-vitro fertilization,IVF)超排卵周期,基础窦卵泡数(basisantral follicle count, bAFC)预测卵巢低反应性的价值。方法 收集国内外有关bAFC与IVF超排卵周期卵巢低反应的相关研究,符合纳入与排除标准的相关文献共11篇,涉及患者11425例,采用RevMan5.2软件对纳入的文献进行meta分析。结果 通过对纳入的11项研究进行meta分析显示,bAFC直接影响获卵数和促性腺激素(Gn)使用量(支),bAFC越多,获卵数越多,促性腺激素(Gn)使用量越少,差异有统计学意义。获卵数(SMD合并-0.87,95%CI:-1.22--0.52;Z=4.84,P<0.00001);促性腺激素(Gn)使用量(支)(SMD合并0.68,95%CI:0.21-1.15;Z=2.83,P=0.005)。结论 bAFC对IVF超排卵周期卵巢低反应性具有预测价值,可作为独立监测指标。
Abstract
Objective To conduct meta-analysis of bAFC prediction of poor ovarian response to ovarian hyperstimulation during IVF cycles.Methods According to inclusion and exclusion criteria, data on related studies of antral follicle count and poor ovarian response was collected via electronic databases. A total of eleven pieces of literature involving 11425 patients were included and meta-analysis was made with RevMan5.2 software.Results Eleven studies were included in the meta-analysis. The Results showed that along with the increase of bAFC, the number of oocytes obtained became larger. bAFC had a direct effect on the number of oocytes retrieved and the amount of gonadotropin (Gn) used.Conclusions Meta-analysis suggests that bAFC can serve both as a predictor of poor ovarian response to ovarian hyperstimulation during IVF cycles and as an independent indicator of surveillance.
关键词
基础窦卵泡数 /
卵巢低反应性 /
体外授精 /
Meta分析
Key words
baseline antral follicle count /
ovarian reaction /
in-vitro fertilization /
meta-analysis
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Ferraretti A P,Goossens V,Moouzon J,et al. Assisted reproductive technology in Europe, 2008: results generated from European registers by ESHRE[J]. Human reproduction (Oxford, England),2012,27(9):2571-2584.
[2] 乔 杰,李红真. 提高辅助生殖技术的成功率[J]. 国际生殖健康/计划生育杂志,2013, 32(1):1-2.
[3] 陈士岭,夏 容,陈 薪,等.基础窦状卵泡数结合年龄用于评估卵巢储备及预测卵巢低反应和体外受精临床结局[J]. 南方医科大学学报,2011,31(4):572-577.
[4] Lamarca A, Papaleo E, Grisendi V, et al. Development of a nomogram based on markers of ovarian reserve for the individualisationof the follicle-stimulating hormone starting dose in in vitrofertilisation cycles[J]. BJOG, 2012, 119(10):1171-1179.
[5] Yovich J, Stanger J, Hinchliffe P. Targeted gonadotrophin stimulation usingthe PIVET algorithm markedly reduces the risk of OHSS[J]. Reprod Biomed Online, 2012, 24(3):281-92.
[6] 刘芳荪,汪希鹏,林其德. 窦卵泡计数及卵巢动脉血流变化与助孕术治疗结局的关系探讨[J]. 生殖与避孕, 2007, 27(5):347-350.
[7] 王丽红,王春光,张海灵,等, IVF-ET治疗高龄不孕时卵巢储备功能预測的临床研究[J].现代妇产科进展杂志, 2013,22(8): 657-659.
[8] Oner G, Muderris. I I. Assessment of ovarian reserve based on hormonal parameters, ovarian volume, and antral follicle count in women with familial Mediterranean fever[J]. Eur J Obstet gynecol Reprod Biol, 2013, 170(2): 449-451.
[9] Panchal S, Nagori C. Comparison of anti-mullerian hormone and antral follicle count for assessment ofovarian reserve[J]. J Hum Reprod Sci,2012, 5(3): 274-278.
[10] Ferraretti A P,Marca A, Fauser B C, et al. ESHRE consensus on the definition of ‘poor response’ to ovarian stimulation for in vitro fertilization: the Bologna criteria[J]. Hum Reprod, 2011, 26(7):1616-1624.
[11] Chang M Y, Chang C H. Useof the antral follicle count to predict the outcome of assisted reproductive technologies[J]. Fertil Steril, 1998, 69(3):505-510.
[12] Dave J,Hendriks. Ultrasonography as a tool for the prediction of outcome in IVF patients: a comparative meta-analysis of ovarian volume and antral follicle count[J]. Fertil Steril, 2007, 87(4):764 -775.
[13] Frattarelli J L, Levi A J, Miller B T, et al. A prospective assessment of the predictive value of basal antral follicles in in vitro fertilization cycles[J]. Fertil Steril, 2003, 80(2):350-355.
[14] Nelson S M. Biomarkers of ovarian response: current and future applications[J]. Fertil Steril, 2013, 99(4):963-969.