血清SHBG、抑制素B对PCOS不孕症患者IVF-ET卵巢反应性的预测价值OA

Objective To investigate the predictive value of serum sex hormone-binding globulin(SHBG)and inhibin B(INHB)in predicting ovarian response to in vitro fertilization-embryo transfer(IVF-ET)in in-fertile patients with polycystic ovary syndrome(PCOS).Methods A total of 405 PCOS infertility patients ad-mitted to Wuhan Sixth Hospital from August 2023 to August 2025 were selected as the research objects.All patients received standard IVF-ET.According to the ovarian response,the PCOS infertility patients were di-vided into high response group,normal response group and low response group.The baseline data of all pa-tients were collected,and the serum SHBG and INHB levels of all patients were detected.Spearman correla-tion was used to analyze the correlation between serum SHBG,INHB levels and ovarian response in PCOS in-fertility patients.Multivariate Logistic regression was used to analyze the influencing factors of high and low ovarian responsiveness in PCOS infertility patients.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum SHBG and INHB levels for high and low ovarian responsiveness in P-COS infertility patients.Results There were 88 cases in the high response group,210 cases in the normal re-sponse group,and 107 cases in the low response group.Compared with the normal response group and the low response group,the high response group was younger,body mass index(BMI),follicle stimulating hormone(FSH)and SHBG levels were lower,the menstrual cycle was longer,antral follicle count(AFC)was more,anti-mullerian hormone(AMH)and INHB levels were higher,and the differences were statistically significant(P＜0.05).Compared with the normal response group,the low response group was older,BMI,FSH and SH-BG levels were higher,the menstrual cycle was shorter,AFC was less,and AMH and INHB levels were lower(P＜0.05).Multivariate Logistic regression analysis showed that older age,increased BMI,increased FSH level,and increased SHBG level were independent protective factors for high ovarian response in PCOS infer-tility patients(P＜0.05).While longer menstrual cycle,more AFC,increased AMH and INHB levels were in-dependent risk factors for high ovarian response in PCOS infertility patients(P＜0.05).Older age,increased BMI,increased FSH level,and increased SHBG level were independent risk factors for poor ovarian response in PCOS infertility patients(P＜0.05).While longer menstrual cycle,more AFC,increased AMH and INHB levels were independent protective factors for poor ovarian response in PCOS infertility patients(P＜0.05).Spearman correlation analysis showed that serum SHBG level was negatively correlated with ovarian respon-siveness(rs=—0.485,P＜0.05),and serum INHB level was positively correlated with ovarian responsive-ness(rs=0.522,P＜0.05).The results of ROC curve analysis showed that the area under the curve(AUC)of serum SHBG and INHB alone and combined detection in predicting high ovarian response in PCOS infertil-ity patients were 0.695,0.782 and 0.884,respectively.The AUC of combined detection was higher than that of single detection(Z=4.557,2.984,P＜0.05).The AUC of SHBG and INHB alone and combined detection in predicting poor ovarian response in PCOS infertility patients were 0.673,0.773 and 0.881,respectively,and the AUC of combined detection was higher than that of single detection(Z=3.137,4.940,P＜0.05).Conclu-sion Serum SHBG and INHB levels are closely related to ovarian response in PCOS infertility patients,and the combined detection of SHBG and INHB has a high predictive value for high and low ovarian response.