Inhibin A and inhibin B reflect ovarian function in assisted reproduction but are less useful at predicting outcome
Inhibin A and inhibin B reflect ovarian function in assisted reproduction but are less useful at predicting outcome
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DOI：
10.1093/humrep/14.2.409
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发表时间：
1999-02-01
影响因子：
6.1
通讯作者：
Cramer, DW
中科院分区：
文献类型：
--
作者：
Hall, JE;Welt, CK;Cramer, DW
为了检验二聚体的卵泡刺激素A和/或卵泡刺激素B浓度代表体外受精（IVF）结果优于促卵泡激素（FSH）的标记物这一假设，将78名在3个辅助生殖治疗周期内妊娠的妇女与78名接受至少3个辅助生殖治疗周期但未能妊娠的妇女进行匹配。在一个周期中，在卵巢刺激前的第1天至第4天之间获得基线血清卵泡素B和FSH，并在排卵刺激前立即测量卵泡素A和B，并在来自主导卵泡的卵泡液中测量。基线时比较妊娠和非妊娠受试者，年龄较小（34.0 +/- 0.5岁vs 36.0 +/- 0.5岁; P < 0.003）与FSH联合低于中位数值（11.2 IU/l）和胆红素B高于中位数（76.5 pg/ml）与妊娠相关（P < 0.03），但FSH（11.7 +/- 0.5 vs 12.9 +/- 0.9 IU/ml）和Bisabin B（89.0 +/- 10.2 vs 79.7 +/- 7.7 pg/ml）不是独立相关的。在排卵刺激时，（52.8 +/- 3.8 vs 40.0 +/- 2.7 IU/ml; P < 0.004），胆红素B（1623.8 +/- 165.1 vs 859.2 +/- 94.8 pg/ml; P < 0.0009）和获卵数（14.6 +/- 0.8对10.1 +/- 0.6; P < 0.0001）在控制年龄时预测妊娠。抑制素A与胚胎数呈正相关（r = 0.4; P < 0.0001）。然而，无论是BABIN A还是BABIN B都没有提供额外的信息来预测年龄和卵母细胞数量的成功结局。我们的结论是：（i）在接受辅助生殖技术的患者中，年龄和获取的卵母细胞数量是成功的最强预测因素;（ii）在周期开始前可用的参数中，低FSH和高FSH结合B与成功结局的更大机会相关，但无法确定绝对截止值;和（iii）在卵巢刺激过程中，血清中较高浓度的卵泡抑素A和卵泡抑素B与成功的IVF相关，并标志着卵巢储备作为卵母细胞数量和质量的量度。
To test the hypothesis that dimeric inhibin A and/or inhibin B concentrations represent improved markers of in-vitro fertilization (IVF) outcome over follicle stimulating hormone (FSH), 78 women who achieved pregnancy within three assisted reproduction treatment cycles were matched to 78 women who underwent at least three assisted reproductive treatment cycles and failed to achieve pregnancy. Baseline serum inhibin B and FSH were obtained between days 1 and 4 in a cycle prior to ovarian stimulation, and inhibin A and B were measured immediately before the ovulatory stimulus and in follicular fluid from the lead follicle. Comparing pregnant and non-pregnant subjects at baseline, younger age (34.0 +/- 0.5 versus 36.0 +/- 0.5 years; P < 0.003) and a combination of FSH lower than the median value (11.2 IU/l) and inhibin B higher than the median value (76.5 pg/ml) were associated with pregnancy (P < 0.03), but FSH (11.7 +/- 0.5 versus 12.9 +/- 0.9 IU/ml) and inhibin B (89.0 +/- 10.2 versus 79.7 +/- 7.7 pg/ml) were not independently associated. At the time of the ovulatory stimulus, serum inhibin A (52.8 +/- 3.8 versus 40.0 +/- 2.7 IU/ml; P < 0.004), inhibin B (1623.8 +/- 165.1 versus 859.2 +/- 94.8 pg/ml; P < 0.0009) and the number of oocytes retrieved (14.6 +/- 0.8 versus 10.1 +/- 0.6; P < 0.0001) were predictive of pregnancy when controlled for age. Inhibin A was correlated with the number of embryos (r = 0.4; P < 0.0001). However, neither inhibin A nor inhibin B provided additional information in predicting successful outcome over age and number of oocytes. We conclude that: (i) in patients undergoing assisted reproductive technology, age and number of oocytes retrieved are the strongest predictors of success; (ii) of the parameters available prior to cycle initiation, a combination of lower FSH and higher inhibin B was associated with a greater chance for a successful outcome but an absolute cut-off could not be defined; and (iii) during ovarian stimulation, higher concentrations of inhibin A and inhibin B in serum are associated with successful IVF and mark ovarian reserve as a measure of oocyte number and quality.