抗苗勒管激素的生理及在临床应用中的新进展

New perspectives of anti-Müllerian hormone in physiology and clinical applications

抗苗勒管激素(Anti-Müllerian hormone,AMH)是一种二聚体糖蛋白,属于转化生长因子β家族中的一员。由生长中的晚期窦前卵泡及小窦卵泡中的颗粒细胞分泌。它是一种比FSH更稳定的可用于评估卵巢储备的标记物,但在妊娠结局的预测方面作用较小。AMH水平可用于辅助生殖技术中指导个体化治疗及患者咨询,指导体外受精-胚胎移植(IVF-ET)中的促性腺激素(Gn)用量,减少由于激素使用不当导致的副作用。另外,有研究将AMH水平用于卵巢功能减退、绝经综合征、多囊卵巢综合征(PCOS)、妇科肿瘤的诊断及治疗评估等。随着对AMH研究的深入,期望AMH能带给临床更多的指导价值。

Anti-Müllerian hormone(AMH)is a dimeric glycoprotein,and a member of the transforming growth factorβfamily.AMH is secreted by granulosa cells in late preantral and small antral follicles.It is a kind of more stable marker than FSH,and is useful in assessment of ovarian reserve.However,it has little effect on the prediction of pregnancy outcome.AMH level can be used for guiding the individual therapy and patients consultation for guiding the dosage of gonadotropin(Gn)in IVF-ET to reduce the side effects caused by improper use of hormone.In addition,some studies have used AMH levels for the diagnosis and treatment evaluation of ovarian dysfunction,menopause syndrome,polycystic ovary syndrome(PCOS),and gynecological tumors.With the deepening of research on AMH,it is expected that AMH can bring more clinical guidance value.