超排卵周期中血清抗苗勒氏管激素及其它卵巢激素预测卵巢反应性的应用价值

Value of serum anti-Mullerian hormone measurement in predicting ovarian response in controlled ovarian hyperstimulation

目的探讨血清抗苗勒氏管激素水平及其它卵巢激素在体外受精-胚胎移植（IVF-ET）/单精子卵泡腔内注射（ICSI）超排卵周期中与卵巢反应性的相关性及其预测价值。方法49例初次接受辅助生殖技术的病人,于IVF/ICSI本周期月经第2-3天及人绒毛膜促性腺激素（hCG）注射日,分别检测血清雌二醇（E2）、孕酮（P）、抗苗勒氏管激素（AMH）水平。根据IVF周期中的获卵数、E2峰值水平的情况。将49例患者分为卵巢正常反应者20例（A组）及卵巢高反应者29例（B组）,比较2组IVF-ET/ICSI临床效果及注射重组卵泡刺激素（rFSH）后AMH、E2及P水平的变化。结果（1）A、B组IVF月经第2-3天（D2）AMH水平分别为（2.100±0.96）ng/ml（、4.49±2.55）ng/ml;IVF周期hCG注射日的AMH水平分别为（0.94±0.29）ng/ml（、2.25±1.55）ng/ml,两组比较差异有统计学意义（P〈0.05）。（2）获卵数与IVF月经第2-3天AMH水平、hCG注射日的AMH水平及P水平呈显著正相关（D2AMH：r=0.822,P〈0.01;hCG注射日P：r=0.474,P〈0.05,hCG注射日AMH：r=0.843,P〈0.01）。结论基础AMH水平I、VF周期hCG注射日的AMH水平均是预测卵巢反应性较好的标记物。

Objective To explore the value of serum anti-Mullerian measurement in predicting ovarianresponse in infertile patients undergoing controlled ovarian hyperst-imulation（COH） for Assisted Reproductive Technology（ART）.Methods A total of 49 patients undergoing their first cycles of ART treatment were studied and serum estradiol（E2）,progesterone（P）,anti-Mullerian hormone（AMH）,serum levels were detected on days 2-3 and HCG injection day.According to number of oocytes and peak E2 concentration,49 patients were allocated into two groups： normal response group（group A）,high response group（group B）.Characteristics of the treatment cycle and AMH,E2,P levels were analyzed.Results（1） In group A,basal serum AMH level,and hCG injection day were（2.100±0.96） ng/ ml,（0.94±0.29） ng/ml respectively.In group B basal serum AMH level,and AMH of hCG injection day were（4.49±2.55） ng/ ml,（2.25±1.55） ng/ ml respectively;（2） There was positive correlation between oocytes number and basal AMH,AMH of hCG injection day and progesterone of hCG injection day（basal AMH： r=0.822,P〈0.01;progesterone of hCG injection day r=0.474,P〈0.05,AMH of hCG injection day： r=0.843,P〈0.01）.Conclusions Basal AMH and AMH of hCG injection day may offer accurate perdicti of ovarian response.