血清抗苗勒管激素检测在IVF中的意义

Significance of serum anti-Müllerian hormone detection in IVF

抗苗勒管激素(AMH)被认为是目前反映卵巢储备功能最可靠的指标,在女性由卵巢初级卵泡、窦前卵泡和小窦卵泡颗粒细胞分泌,血清AMH水平不受月经周期和外源性性激素的影响,与窦卵泡数量和生殖年龄密切相关。通过检测血清AMH水平可了解卵巢储备状态,预测卵巢反应性,制定个体化促排卵方案,最大限度地获得妊娠机会及消除因卵巢刺激所带来的医源性风险和减少周期取消风险,AMH作为卵巢储备的有用指标在辅助生殖中能很好地预测获卵数,但对卵子质量的预测价值却存在争议,而对IVF出生率的预测,AMH至少可通过预测获卵数间接地起到预测作用。

The level of serum anti-Müllerian hormone（AMH）has been demonstrated to be the most reliable marker for the ovarian reserve function. AMH is produced by granulose cells of primary,preantral and early antral follicle. The serum AMH level has been shown to not fluctuate across the menstrual cycle and influence by exogenous sex hormones treatment, but it is closely related to the number of antral follicles and reproductive age. The significance of detecting serum AMH level included： finding out ovarian reserve status, predicting ovarian response to stimulation, drawing up individualized controlled ovarian stimulation to maximize the opportunity to get pregnant, eliminating iatrogenic risk due to ovarian stimulation and reducing the risk of cycle cancellation. AMH as a useful marker of ovarian reserve in assisted reproduction can well predict the number of oocytes retrieved, but it is still controversy in predicting oocyte quality. However,AMH may indirectly reflect the live birth rate of IVF by predicting the number of oocytes retrieved.