摘要
目的探讨血清及卵泡中抗米勒管激素(anti-Müllerian hormone,AMH)、生长分化因子9(growth differentiation factor 9,GDF9)水平对不孕症患者生育能力的预测价值。方法选取2020年4月至2023年2月浙江中医药大学附属湖州中医院收治的200例不孕症患者为研究组,根据窦卵泡数目及卵巢最大平面直径分为生育能力良好组(n=114)和生育能力不良组(n=86);另选取同期132名健康体检女性为对照组。收集研究对象的一般资料与临床资料,比较研究组和对照组的血清AMH、GDF9水平;比较生育能力良好组和生育能力不良组患者的血清和卵泡AMH、GDF9水平;分析不孕症患者生育能力的影响因素;不孕症患者的血清AMH、GDF9水平与卵泡刺激素(follicle-stimulating hormone,FSH)、黄体生成素(luteinizing hormone,LH)、雌二醇水平的相关性采用Pearson相关性分析;受试者操作特征曲线分析血清AMH、GDF9水平对不孕症患者生育能力的预测价值。结果与对照组比较,研究组患者的血清AMH和GDF9水平显著降低(P<0.05)。与生育能力良好组比较,生育能力不良组患者的血清及卵泡中AMH、GDF9水平均显著降低(P<0.05)。与生育能力良好组比较,生育能力不良组患者的FSH水平、不孕年限>2年占比、促排卵次数>2次占比、卵巢间质动脉血流搏动指数、阻力指数均显著升高,获卵数、窦卵泡数目、收缩期最大血流速度和LH、雌二醇水平均显著降低(P<0.05)。不孕症患者的血清AMH和GDF9水平与FSH水平呈负相关(r<0,P<0.05),与LH和雌二醇水平呈正相关(r>0,P<0.05)。血清及卵泡AMH、血清及卵泡GDF9、获卵数、FSH、LH、窦卵泡数目、收缩期最大血流速度是不孕症患者生育能力的影响因素(P<0.05)。AMH和GDF9联合诊断不孕症患者生育能力的曲线下面积显著大于AMH、GDF9单独预测(P<0.05)。结论不孕症患者的血清及卵泡中AMH和GDF9水平与其生育能力有关,血清AMH和GDF9水平对其�
Objective To explore predictive value of serum and follicular anti-Müllerian hormone(AMH)and growth differentiation factor 9(GDF9)levels on fertility in infertile patients.Methods From April 2020 to February 2023,200 infertile patients admitted to Huzhou Hospital of Traditional Chinese Medicine Affiliated Zhejiang Chinese Medicine University were selected as study group.According to number of antral follicles and maximum diameter of ovarian plane,they were divided into good fertility group(n=114)and poor fertility group(n=86).In addition,132 healthy women in same period were selected as control group.General and clinical data of subjects were collected,serum AMH and GDF9 levels were compared between study group and control group;serum and follicular fluid AMH and GDF9 levels were compared between good fertility group and poor fertility group;influencing factors of fertility of infertile patients were analyzed;correlation between serum AMH and GDF9 levels and follicle-stimulating hormone(FSH),luteinizing hormone(LH)and estradiol levels of infertile patients were analyzed by Pearson correlation analysis;and predictive value of serum AMH and GDF9 levels on fertility of infertile patients was analyzed by receiver operating characteristic curve.Results Compared with control group,serum AMH and GDF9 levels in study group were significantly decreased(P<0.05).Compared with good fertility group,AMH and GDF9 levels in serum and follicles of poor fertility group were significantly decreased(P<0.05).Compared with good fertility group,FSH level,proportion of infertility years more than two years,proportion of ovulation promotion number more than two times,pulsatility index of ovarian interstitial artery and resistance index inpoor fertility group were significantly increased,number of eggs obtained,number of sinus follicles,peak systolic velocity,LH and estradiol levels were significantly decreased(P<0.05).Serum AMH and GDF9 levels in infertility patients were negatively correlated with FSH level(r<0,P<0.05),and positively c
作者
薛建芳
XUE Jianfang(Department of Gynecology,Huzhou Hospital of Traditional Chinese Medicine Affiliated Zhejiang Chinese Medicine University,Huzhou 313000,Zhejiang,China)
出处
《中国现代医生》
2024年第15期54-58,共5页
China Modern Doctor
基金
湖州市科技计划项目(2019GYB34)。
关键词
不孕症
生育能力
抗米勒管激素
生长分化因子9
Infertility
Fertility
Anti-Müllerian hormone
Growth differentiation factor 9
