抗苗勒激素对体外受精-胚胎移植结局的预测作用

Anti-müllerian Hormone Has an Predictive Effect on the Outcome of In Vitro Fertilization-Embryo Transfer

目的:研究行体外受精-胚胎移植(IVF-ET)的患者血清及卵泡液中抗苗勒激素(AMH)与胚胎质量、妊娠结局之间的关系。方法:酶联免疫吸附实验(ELISA)检测48例行IVF-ET患者(48个周期)取卵日、胚胎移植日和胚胎移植后3 d血清中AMH水平及取卵日卵泡液中AMH水平,了解其与胚胎质量、妊娠结局之间的关系。结果:⑴高质量胚胎比≥0.5组卵泡液AMH水平较高质量胚胎比<0.5组显著升高(P<0.05);⑵在妊娠组与非妊娠组之间,取卵日、胚胎移植日和胚胎移植后3 d血清中AMH水平无差异(P>0.05);⑶妊娠组卵泡液AMH水平明显高于非妊娠组(P<0.05)。结论:取卵后各个时期的血清AMH水平不能预测IVF-ET妊娠结局,取卵日卵泡液中AMH水平可以作为IVF-ET妊娠结局的预测因子。卵泡液中AMH可能通过改变局部微环境引起胚胎质量的改变,进而影响IVF-ET结局。

Objective To study the relationships between anti-müllerian hormone in serum and follicular fluid and embryonic quality and successful pregnancy.Methods Enzyme-linked immunosorbent assay(ELISA)was used to detect anti-müllerian hormone(AMH) levels in serum on the day of oocyte pick-up(OPU),embryo transfer(ET),ET+3 and in follicular fluid on the day of OPU in 48 patients(48 cycles) undergoing in vitro fertilization-embryo transfer(IVF-ET).Results⑴The AMH concentrations in follicular fluid of patients whose high-quality embryonic ratio is no less than 0.5 are significantly higher than those whose high-quality embryonic ratio is less than 0.5(P<0.05).⑵Between the pregnant group and non-pregnant group,there is no difference in the AMH concentrations of every stage in serum(P>0.05,respectively).⑶However,the AMH concentration in follicular fluid of pregnant group are markedly higher than non-pregnant group(P<0.05).Conclusion The AMH levels of every stage after OPU in serum can not predict the outcome of IVF-ET.The AMH concentration in follicular fluid is a factor that could be used to predict the outcome of IVF-ET.It may lead to the change of embryonic quality by altering follicular microenvironment locally and then affecting the outcome of IVF-ET.