抗苗勒氏管激素在多囊卵巢综合征患者IVF-ET中的应用

Application of anti-mullerian hormone to IVF-ET of patients with polycystic ovary syndrome

目的:探讨多囊卵巢综合征(PCOS)患者血清及卵泡液中抗苗勒氏管激素(AMH)水平在控制性卵巢超促排卵(COH)过程中的变化,及其对IVF-ET结局的预测价值。方法:选择行IVF-ET助孕的PCOS患者60例及因输卵管因素行IVF-ET助孕的患者30例,比较两组患者AMH水平及各实验室指标,分析AMH在超促排卵过程中的变化及其与妊娠结局的关系。结果:PCOS组血清AMH及卵泡液AMH(FF AMH)水平均显著高于对照组,差异有统计学意义(P<0.05);两组患者HCG日血清AMH水平显著低于Day3、Gn日及FF AMH(P<0.05);两组患者的正常受精率、优质胚胎率及临床妊娠率比较差异均无统计学意义(P>0.05);PCOS妊娠组AMH水平与未妊娠组比较,差异无统计学意义(P>0.05)。结论:PCOS患者经COH后AMH水平显著降低;血清及卵泡液AMH水平均不能预测PCOS患者IVF妊娠结局。

Objective： To investigate the changes of the serum and AMH levels in the serum and follicular fluid in patients with polycystic ovary syndrome （PCOS） in the process of controlled ovarian hyperstimulation （COH） and its predictive value for the outcome of IVF-ET. Methods： 60 cases of PCOS patients with IVF-ET assisted pregnancy and 30 cases of IVF-ET assisted pregnancy due to fallopian tube factors were selected. The level of AMH and the laboratory indexes in both groups were compared, and the changes of AMH in the process of ovulation and its relationship with the pregnancy outcome were analyzed. Results ： The serum and follicular fluid AMH in patients of PCOS group were significantly higher than those of the control group, which were of statistical differences （P〈0.05） ; serum AMH in HCG injection day were significantly lower than that in the 3rd d, Gn injection day and in the follicular fluid（P〈0.05） ; there were no statistical differences of normal fertilization rates, top quality embryos rate and clinical pregnancy in both groups （P 〉0.05） ; and no difference of AMH was found between the PCOS group and the no pregnancy group （P〈0.05）. Conclusion： The AMH level of PCOS patients controlled ovarian hyperstimulation. The serum and follicular fluid AMH level outcome.