抗苗勒管激素对卵泡发育的影响

Influence of Serum Anti-müllerian Hormone Basal Levels on Ovulation Induction

目的探讨血清抗苗勒管激素(AMH)水平对促排卵效果的影响。方法排卵障碍患者70例,其中多囊卵巢综合征(PCOS)40例(PCOS组),非PCOS者30例(非PCOS组),尿促性素(hMG)促排卵。月经周期2～3d(基础日)及注射绒促性素(hCG)日抽取空腹静脉血测AMH、雌激素(E)及雄激素(T)水平,分析血清AMH水平与促排卵效果的关系。20例健康妇女做正常对照。结果PCOS组血清基础AMH为(48.2±18.3)pmol/L,明显高于非PCOS组及对照组(P<0.01),后两组间的基础AMH差异无统计学意义。非PCOS组基础AMH水平低者,促排卵药用量大,获得的成熟卵泡少;而PCOS组基础AMH水平低者促排卵药用量小,获得的成熟卵泡多。结论血清基础AMH水平对不同排卵障碍患者的影响是不同的,PCOS患者血清基础AMH水平低,促排卵效果好,而非PCOS患者血清基础AMH水平低,预示促排卵效果差。

Objective To observe the influence of serum anti-mtillefian hormone （ AMH ） basal levels on ovulation induction. Methods Seventy patients of anovulatory patients were treated with human menopausal gonadotrupin （hMG） for ovulation induction. Among them, 40 suffered from polycystic ovary syndrome （PCOS） （PCOS group） , and the other 30 suffered from non.PCOS （ non-PCOS group）. Fasting serum levels of AMH, estradiol （E） , and testosterone （T） were measured on the second （ or third） day of menstrual cycles （ basal day） and hCG-injection day, respectively. The influence of serum AMH basal levels on ovulation induction were evaluated. Twenty age-matched healthy women were chosen as controls. Results The serum basal AMH level in the PCOS group was 48.2 ± 18.3 pmol/L, significantly higher than that in the non-PCOS group and that in the controls （ P 〈 0.01 ）, and the difference between the later two groups was not Significant. In the non-PCOS group, the lower the basal AMH level was, the more the hMG was needed, and the fewer the mature follicles were obtained. On the contrary in the PCOS group, if the basal AMH level was lower, less hMG was needed and more mature follicles were obtained. Conclusion The influence of serum AMH basal levels on ovulation induction is different, which depends on the anovulatory causes.