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대한생식의학회지 제24권 제2호 2010년
보조 생식술 결과에 있어서 기저혈중 Inhibin-B의 예후인자로서의 유용성
연세대학교 의과대학 산부인과학교실;연세대학교 의과대학 산부인과학교실;연세대학교 의과대학 산부인과학교실;연세대학교 의과대학 산부인과학교실;연세대학교 의과대학 산부인과학교실;연세대학교 의과대학 산부인과학교실;연세대학교 의과대학 산부인과학교실;연세대학교 의과대학 산부인과학교실;연세대학교 의과대학 산부인과학교실;연세대학교 의과대학 산부인과학교실;연세대학교 의과대학 산부인과학교실;
배상욱;김진영;이경술;원종건;이용주;이지원;장경환;이병석;박기현;조동제;송찬호;,
Prognostic Value of Day 3 Inhibin-B on Assisted Reproductive Technology Outcome
Bai, Sang-Wook;Kim, Jin-Young;Lee, Kyung-Sool;Won, Jong-Gun;Lee, Yong-Joo;Yi, Ji-Won;Chang, Kyung-Hwan;Lee, Byung-Seok;Park, Ki-Hyun;Cho, Dong-Jae;Song, Chan-Ho;
Department of Obstetrics & Gynecology, College of Medicine, Yonsei University;Department of Obstetrics & Gynecology, College of Medicine, Yonsei University;Department of Obstetrics & Gynecology, College of Medicine, Yonsei University;Department of Obstetrics & Gynecology, College of Medicine, Yonsei University;Department of Obstetrics & Gynecology, College of Medicine, Yonsei University;Department of Obstetrics & Gynecology, College of Medicine, Yonsei University;Department of Obstetrics & Gynecology, College of Medicine, Yonsei University;Department of Obstetrics & Gynecology, College of Medicine, Yonsei University;Department of Obstetrics & Gynecology, College of Medicine, Yonsei University;Department of Obstetrics & Gynecology, College of Medicine, Yonsei University;Department of Obstetrics & Gynecology, College of Medicine, Yonsei University;
This study was performed to determine if women with day 3 serum inhibin-B concentrations <45pg/ml (conversion factor to SI unit, 1.00) demonstrate a poor response to ovulation induction and assisted reproductive technology outcome to women with inhibin-B${\ge}45pg$/ml, independant of day 3 FSH, E2 and patient age. From Jan 1996 to Dec 1996, 16 volunteers patients who underwent 25 IVF cycles with luteal phase GnRH agonist suppression and HMG stimulation were allocated to the study group. We evaluated day 3 serum inhibin-B, FSH, E2, peak E2, cancellation rate per initiated cycle (%) and clinical pregnancy rate per initiated cycle (%) according to the above two groups and independent of patient age, day 3 FSH, day 3 E2 and all of above combined. Women with day 3 serum inhibin-B${\ge}45pg$/ml demonstrated higher average day 3 inhibin-B level, clinical pregnancy rate per initiated cycle ($20.3{\pm}2.5$ pg/ml vs $80.9{\pm}5.0$ pg/ml, p<0.05; 24.8% vs 8.5%, p<0.05) and lower day 3 FSH level, cancellation rate per initiated cycle ($6.9{\pm}0.3$ mIU/ml vs $8.5{\pm}0.5$ mIU/ml, p<0.05; 1.5% vs 9.0%, p<0.05). Women with day 3 serum inhibin${\ge}45pg$/ml and age<40 year demonstrated higher pregnancy rate per initiated cycle (28.2% vs 7.4%, p<0.05) and lows. day 3 FSH level, cancellation rate per initiated cycle ($6.9{\pm}0.5$ mIU/ml vs $8.2{\pm}0.7$ mIU/ml, p<0.05; 1.0% vs 9.0%, p<0.05). Women with day 3 serum inhibin${\ge}45pg$/ml and day 3 FSH<15mIU/ml demonstrated higher pregnancy rate per initiated cycle (33.5% vs 9.5%, p<0.05) and lower day 3 FSH level, cancellation rate per initiated cycle ($7.7{\pm}0.2$ mIU/ml vs $8.5{\pm}0.5$ mIU/ml, p<0.05; 1.5% vs 10.0%, p<0.05). Women with day 3 serum inhibin${\ge}45pg$/ml and day 3 E2<50pg/ml demonstrated higher pregnancy rate per initiated cycle (30.0% vs 9.5%, p<0.05) and lower cancellation rate per initiated cycle (1.5% vs 9.5%, p<0.05). Women with day 3 serum inhibin${\ge}45pg$/ml, age<40 year, day 3 FSH<15mIU/ml and day 3 E2<50pg/ml demonstrated higher pregnancy rate per initiated cycle (30.0% vs 10.8%, p<0.05) and lower day 3 FSH level, cancellation rate per initiated cycle ($6.8{\pm}0.6$ mIU/ml vs $8.4{\pm}0.9$ mIU/ml, p<0.05; 1.5% vs 7.8%, p<0.05). Therefore women with low day 3 serum inhibin-B concentrations demonstrate a poorer response to ovulation induction and are less likely to conceive a clinical pregnancy though ART relative to women with high day 3 inhibin-B and day 3 serum inhibin-B, in addition to a day 3 FSH, E2 and patient age, appears helpful in prediction in IVF-ET outcome.
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