摘要
目的探讨血清抗苗勒氏管激素水平(AMH)在辅助生殖超排卵周期中预测卵巢反应性的价值。方法按获卵数及人绒毛膜促性腺激素(hCG)注射日雌二醇(E2)水平,将68例接受体外受精-胚胎移植(IVF-ET)/体外受精-胞浆内单精子注射(ICSI)的不孕症患者分为卵巢低反应组(A组)、卵巢正常反应组(B组)及卵巢高反应组(C组)。于促排周期月经第2天及hCG注射日,分别检测血清AMH、E2及孕酮(P)水平。比较3组临床效果及注射rFSH后AMH、E2、黄体生成素(LH)及P水平的变化。按妊娠结局分为妊娠组和非妊娠组,比较AMH、窦卵泡数(AFC)、优质胚胎率、优质胚胎数的变化。结果①A、B、C 3组月经第2天(D2)AMH水平的M分别为0.645、1.762及3.101 ng/mL;IVF周期hCG日AMH水平M分别为0.331、0.898及1.434 ng/mL,3组比较差异有统计学意义(P<0.001);多重比较后均发现D2AMH及hCG日AMH差异有统计学意义(P<0.001)(C组>B组>A组)。②获卵数与促排周期D2AMH、hCG日AMH、AFC(窦卵泡数)、P呈显著正相关;与促排周期D2卵泡刺激(FSH)、促性腺激素(GN)量呈负相关。③卵巢过度刺激综合征(OHSS)的发生和GN量、AFC、D2AMH、HCG日E2及HCG日AMH水平均成正相关;与D2FSH成负相关。④妊娠组和未妊娠组间的卵裂率、优胚率及优质胚胎数间有差异性(P<0.05)。结论①D2AMH、hCG日的AMH水平及AFC均是预测卵巢反应性较好的标记物;②D2AMH、hCG日AMH及hCG日E2水平对预测OHSS的发生具有一定的指导意义;③AMH水平不能预测妊娠结局。
【Objective】To explore the value of serum anti-Mullerian measurement in predicting ovarian response in infertile patients undergoing controlled ovarian hyperstimulation（COH） for assisted reproductive technology（ART）.【Methods】A total of 68 patients undergoing their cycles of IVF/ICSI treatment were studied.According to the number of oocytes and peak E2 concentration,the 68 patients were allocated into three groups： poor ovarian response group（group A）,normal response group（group B） and high response group（group C）.Serum estradiol（E2）,progesterone（P） and anti-Mullerian（AMH） levels were detected on the 2nd day of the treatment cycle and hCG injection day;and AMH,E2,P and LH levels were analyzed and compared among the three groups.According to the outcome of pregnancy the ET-patients were allocated into two groups： pregnant group and nonpregnant group and then the differences in AMI,AFC,good embryo rate and number were compared between them.【Results】（1） In group A,basal serum AMH level and AMH level on hCG injection day were significantly different from those of other groups（P 0.001）,basal serum AMH level and AMH on hCG injection day were 0.645 ng/mL and 0.331 ng/mL respectively.In group B,basal serum AMH level and AMH of hCG injection day were 1.762 ng/mL and 0.898 ng/mLrespectively.In group C,basal serum AMH level and AMH of hCG injection day were 3.101 ng/mL and 1.434 ng/mLrespectively.Through the multiple compare we found the level of the D2 AMH and the hCG AMH had such a ruleas group Cgroup B group A（P 0.001）.（2） There was a positive correlation between oocyte number and basalAMH,AMH of hCG injection day,AFC and progesterone of hCG injection day.There was a negative correlation be-tween oocyte number and basal FSH and the quantity of GN.（3） There was a positive correlation between OHSS andthe quantity of GN,AFC,D2AMH,hCG E2,hCG AMH.There was a negative correlation between OHSS and oocytenumber and basal FSH.（4） There was difference between oo
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2010年第8期1210-1214,共5页
China Journal of Modern Medicine
关键词
抗苗勒氏管激素
窦卵泡数
卵巢反应
anti-Mullerian hormone
antral follicle count
ovarian reserve
