抗苗勒管激素与多囊卵巢不孕患者有无排卵的相关关系

Relationship between serum anti-mullerian hormone and ovulation in women with polycystic ovaries

目的研究抗苗勒管激素(AMH)与多囊卵巢(PCO)不孕患者有无排卵的关系,探讨AMH在卵巢卵泡生长和发育停滞中的作用。方法采用酶联免疫吸附法(ELISA)检测35例正常卵巢形态的排卵妇女(A组)、29例PCO伴正常排卵妇女(B组)和38例PCO伴排卵障碍妇女(C组)的月经第2d(d2)血清及排卵前卵泡液(FF)的AMH水平。结果B组和C组的月经d2血清AMH水平比较,差异无显著性(5.87ng/ml和7.99ng/ml;P>0.05),但显著高于A组(2.52ng/ml;P<0.01)。月经d2血清AMH与小窦泡卵数呈正相关(r=0.53;P<0.05)。B组和C组排卵前单卵泡FF的AMH水平比较,差异无显著性(54.77ng/gpro和64.05ng/gpro;P>0.05),但显著高于A组(29.45ng/gpro;P<0.05)。结论多囊卵巢患者血清AMH水平升高,其颗粒细胞可能存在AMH分泌异常,但多囊卵巢患者AMH水平的增高可能不是造成卵泡生长停滞的原因。

Objectives To compare anti- Mullerian hormone （AMH） in normoovulatory and anovulatory women with PCO and analyze the relationship between AMH and the follicular arrest of the infertile women with PCO. Methods Thirty- five normoovulatory women with normal ovarian morphology （group A, control）, 29 normoovulatory women with PCO （group B） and 38 anovulatory women with PCO （group C）, underwent controlled ovarian hyperstimulation （COH） with the short protocol, were recruited in this study. Serum AMH on the second day （d2） of the menstruation and AMH in follicular fluid （FF） on the day of oocyte pickup （dOPU） were measured using enzyme - linked immunosorbent assay （ELISA）. Results No significant difference in serum AMH was found between group B and C （5.87 ng/ml vs. 7.99 ng/ml; P〉0.05）, but both were significantly higher than group A （2. 52 ng/ml; P〈0. 01）. FF AMH bad no significant difference between group Band C （54. 77 ng/g pro vs. 64. 05 ng/g pro; P〉0.05）, but markedly higher than group A （29.45 ng/g protein; P〈0.05）. Significant correlation was found between serum AMH and follicle number on d2. Conclusions Serum and FFAMH elevate in PCO group suggests that AMH secreted by granulose cells might increase in PCO women. No significant difference in serum and FF AMH between normoovulatory and anovulatory women with PCO suggests that an increased AMH might not related to follicular arrest.