抗苗勒管激素在不同年龄段女性生育功能预测中的运用价值探讨

Discussion on the application value of anti-Müllerian hormones in fertility prediction in women of different ages

目的研究抗苗勒管激素(AMH)在月经规律生育期女性各个年龄段的水平变化,从而探索抗苗勒管激素在实际临床工作中评估卵巢功能和选择临床治疗方案中的运用价值。方法选取2017年9月~2018年9月在西南医科大学附属医院不孕不育中心就诊的2986例月经规律生育期女性按年龄分为A组(≤25岁)、B组(26≤X<30岁)、C组(30≤X<35岁)、D组(35≤X<40岁)、E组(≥40岁),检测各年龄段的抗苗勒管激素水平,分析各组之间与年龄的关系。结果(1)年龄与AMH间存在负相关关系,年龄越大,AMH值越小。(2)各年龄段两两比较组间差异均有统计学意义,可认为AMH值在A组(≤25岁)、B组(26≤X<30岁)、C组(30≤X<35岁)、D组(35≤X<40岁)、E组(≥40岁)年龄组依次降低。(3)以AMH值为因变量,年龄为自变量,进行回归模型分析,最终判断增长曲线为最优拟合曲线,反应AMH值与年龄之间的关系。结论AMH结合年龄的综合评估,可以成为我们在评价女性生育力的预测和指导依据之一,对我们进一步的临床治疗方案有指导和预测价值。

Objective To investigate the level changes of anti-Müllerian hormone(AMH)in reproductive women of different ages with regular menstruation,and to explore the application value of anti-Müllerian hormone in assessing ovarian function and selecting clinical treatment regimen in clinical practice.Methods 2986 reproductive women with regular menstruation who visited the Infertility Center of Affiliated Hospital of Southwest Medical University from September 2017 to September 2018 were selected and divided into group A(≤25 years old),group B(26≤X<30 years old),group C(30≤X<35 years old),group D(35≤X<40 years old)and group E(≥40 years old)according to the age.The anti-Müllerian hormone levels of each age group were detected and the relationship between AMH values and the age was analyzed.Results(1)There was a negative correlation between the age and AMH values.The older the age,the smaller the AMH values.(2)There were statistically significant differences in pairwise comparison between different age groups.It could be considered that the AMH values were sequentially decreased in group A(≤25 years old),group B(26≤X<30 years old),group C(30≤X<35 years old),group D(35≤X<40 years old)and group E(≥40 years old).(3)The regression model analysis was conducted with AMH value as the dependent variable and with age as the independent variable.Finally,the growth curve was considered to be the best fit curve,which reflected the relationship between the AMH value and the age.Conclusion The comprehensive assessment of AMH combined age can be one of the predictive and guiding criteria for evaluating female fertility,which has guiding and predictive value for the further clinical treatment options.