The prediction of ovarian response in in vitro fertilization-embryo transfer cycles

摘要

Objective:To indentify the predictive parameters of ovarian response in in vitro fertilization-embryo transfer(IVF-ET)cycles,Methods:one hundred and six patients were administered GnRH-a/ rFSH/ human chorionic gonadotrophin(HCG)for ovarian stimulation.The following predictive parameters were examined,age,the basal level of FSH,mean ovarian volume,total of antral follicle count(AFC),the ratio of FSH/LH and the concentration of inhibin B after down-regulation.Ovarian response was assessed by the number of oocytes retrieved and the dosage of gonado-trophins(Can)used.Results:Correlations between predictive parameters and assessment indices of ovarian response were as follows:The basal FSH level and the ratio of FSH/LH showed a negative correlation with the number of oocyte obtained(r =-0.192,r=-0.227,respectively),while AFC and the concentration of inhibin B after down-regulation posi-tively correlated with the number of oocyte obtained(r=0.316,r=0.523,respectively),AFC,the mean ovarian volume and the concentration of inhibin B after down-regulation showed a negative correlation with the dosage of Gn used(r=-0.245,r=-0.294,r=-0.241,respectively),the ratio of FSH/ LH showed a positive correlation with the dosage of Gn used(r=0.255).Multiple regression analysis showed that inhibin B was the best predictor for the number of retrieved oocyte,followed by AFC,while the ovarian volume was the most important predictive parameter for the dosage of Gn used,then the ratio of FSH/LH.Conclusions:The level of inhibin B after down-regulation is the best predictor of ovarian response in IVF-ET.However,it's not yet a widely available test due to its high cost.AFC,by simple,non-invasive trsnsvaginal ultra-sound scan,could be the first applicable option in predicting ovarian response before IVF treatment.