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临床输血与检验

临床输血与检验 ›› 2019, Vol. 21 ›› Issue (5): 531-534.DOI: 10.3969/j.issn.1671-2587.2019.05.025

• 临床检验 • 上一篇    下一篇

AMH水平预测PCOS患者行辅助生殖技术超促排卵结果的价值

蒋其, 许耀辉, 李娜   

  1. 214001 南京医科大学附属无锡市妇幼保健院检验科
  • 收稿日期:2018-06-23 出版日期:2019-10-20 发布日期:2019-10-29
  • 通讯作者: 许耀辉,男,副主任检验师,（E-mail）sunshing982503@163.com。
  • 作者简介:蒋其（1988-）,女,江苏宜兴人,检验师,主要从事妇幼保健工作,（E-mail）jiangqi0701@126.com。
  • 基金资助:
    *本课题受无锡市发展医疗卫生指导性计划项目（No.CSZ0N1417）资助

Anti-Mullerian Hormone and Superovulation： The Predictive Value in Patients with PCOS during Assisted Reproduction

JIANG Qi, XU Yao-hui, LI Na   

  1. Clinical Laboratory of Maternity and Child Health Care Hospital of Nanjing Medical University, Jiangsu214001
  • Received:2018-06-23 Online:2019-10-20 Published:2019-10-29

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摘要： 目的 分析卵泡液及取卵日血清的抗苗勒氏管激素水平,预测多囊卵巢综合征患者行辅助生殖技术超促排卵结果的价值。方法 入选无锡市妇幼保健院2015年2月~2017年6月收治的48例PCOS患者（行IVF-ET治疗）为实验组,入选52例同期输卵管性不孕患者（行IVF-ET治疗）为对照组。 比较两组患者卵泡液及取卵日血清中AMH水平、IVF-ET治疗周期的临床特征、妊娠与未妊娠患者卵泡液及血清中AMH水平,结合卵泡数进行统计分析。结果 实验组卵泡液AMH及取卵日血清AMH值为（7.4±4.1）ng/mL、（3.9±2.1）ng/mL,对照组卵泡液AMH及取卵日血清AMH值为（3.5±1.9）ng/mL、（1.7±1.1）ng/mL,差异有统计学意义（t=6.180,P<0.05;t=5.500,P<0.05）;实验组共获取卵泡998个,获卵数570个,对照组共获取卵泡687个,获卵数476个,实验组与对照组受精率、优质胚胎率、临床妊娠率、早期流产率、继续妊娠率比较,差异无统计学意义[64.1% vs 69.4%,（39.3±26.5）% vs （38.8±23.4）%,45.8% vs 46.2%,18.2% vs 12.5%,37.5% vs 40.4%,P>0.05],而获卵率、卵子成熟率比较,差异有统计学意义（57.1% vs69.3%,77.9% vs 88.2%,P<0.05）;比较实验组妊娠与未妊娠患者卵泡液AMH、血清AMH值[（10.7±4.1）% vs （4.5±1.7）%,（5.2±2.0）% vs （3.0±1.5）%,P<0.05],对照组妊娠与未妊娠患者优质胚胎率、卵泡液AMH、血清AMH值分别为[（50.7±18.4）% vs （27.2±21.2）%,（4.7±2.1）% vs （2.2±1.1）%,（1.9±1.0）% vs （1.2±0.6）%,P<0.05]。结论 卵泡液及血清AMH值可反映PCOS患者行IVF-ET过程中的临床特征,预测PCOS患者IVF-ET超促排卵周期卵巢反应性,但不能预测IVF-ET后的妊娠结果。

关键词: 抗苗勒氏管激素, 辅助生殖技术, 多囊卵巢综合征

Abstract: Objective To analyze the value of anti-Mullerian hormone （AMH） in sera and follicular fluids on the day of oocyte retrieval to predict the outcome of superovulation in vitro fertilization in those with polycystic ovary syndrome （PCOS）. MethodForty eight patients with IVF-ET were selected as group PCOS and 52 with oviduct infertility treated with IVF-ET as the control. The general condition,AMH in sera and the follicle fluids of the pregnant and non-pregnant patients,and clinical features of the IVF-ET treatment cycle were compared.Results The levels of AMH in the sera and follicle fluids of group PCOS were （7.4±4.1） ng/mL and （3.9±2.1） ng/mL,respectively,which was higher than those of the control [（3.5±1.9） ng/mL and （1.7±1.1） ng/mL （t=6.180,P<0.05; t=5.500,P<0.05]. A total of 998 ovarian follicles and 570 eggs were obtained in group POCS,while 687 follicles and 476 eggs were obtained in the control. There was no significant difference in the rates of normal fertilization,high quality embryo,clinical pregnancy,early abortion as well as continuing pregnancy between the two groups [64.1% vs 69.4%,（39.3±26.5）% vs （38.8±23.4）%,45.8% vs 46.2%,18.2% vs 12.5%,and 37.5% vs 40.4%,P>0.05]. However,the rates of obtained eggs and egg maturation varied （57.1% vs 69.3%,77.9% vs 88.2%,P<0.05）. The difference existed in the AMH levels of follicle fluids and sera between pregnant and non-pregnant patients in POCS patients [（10.7±4.1）% vs （4.5±1.7）%,（5.2±2.0）% vs （3.0±1.5）%,P<0.05]. A significant difference was seen in the ratio of high quality embryos,AMH of follicular fluids and sera between pregnancy and non-pregnancy patients in the control group （50.7±18.4）% vs （27.2±21.2）%,（4.7±2.1）% vs （2.2±1.1）%,（1.9±1.0）% vs （1.2±0.6）%,and P<0.05].Conclusion The AMH value in follicular fluids and sera may reflect the clinical features of PCOS during IVF-ET process and help to predict the superovulation outcomes of IVF cycle in PCOS patients but not the outcomes of pregnancy after IVF-ET.

Key words: Anti-Mullerian hormone, Assisted reproductive technique, Polycystic ovary syndrome

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