AMH水平筛查在孕前隐匿性卵巢储备功能降低诊断中的应用效果

The application effect of AMH level screening in the diagnosis of latent ovarian reserve dysfunction before pregnancy

目的探讨血清抗苗勒氏管激素(AMH)在孕前隐匿性卵巢储备功能降低诊断中的应用效果。方法选取2017年1月至2019年3月本院收治的孕前卵巢储备功能降低患者118例(降低组),卵巢储备功能正常者64例(正常组),卵巢储备功能高反应者94例(升高组)作为研究对象。在月经周期第2~5天采集静脉血标本开展促黄体生成素(LH)、促卵泡成熟激素(FSH)、AMH水平检测。采用阴超测量双侧卵巢基础窦卵泡数量(AFC)。比较3组各项指标水平、妊娠率及指标诊断孕前隐匿性卵巢储备功能的价值。结果降低组FSH水平高于正常组与升高组(P<0.05);降低组、正常组与升高组LH、AMH水平与AFC个数呈逐渐升高趋势(P<0.05);正常组临床妊娠率为65.63%,高于升高组的38.30%与降低组的17.80%,差异有统计学意义(P<0.05);AMH水平检测前隐匿性卵巢储备功能的灵敏度为92.02%,特异度为88.27%。结论AMH水平筛查在孕前隐匿性卵巢储备功能降低诊断中的应用效果较好,可准确评估卵巢储备功能,且不易受其他因素影响,效果优于传统指标。

Objective To investigate the effect of serum anti Mullerian hormone(AMH)in the diagnosis of latent ovarian reserve dysfunction before pregnancy.Methods From January 2017 to March 2019,118 patients with decreased ovarian reserve function(the decrease group),64 with normal ovarian reserve function(the normal group)and 94 with high response to ovarian reserve function(the increase group)who were admitted in our hospital were selected as the study subjects.The levels of LH,FSH and AMH were measured on the 2nd to 5th day of menstrual cycle.The number of ovarian follicles(AFC)in bilateral ovarian basal sinuses was measured by transvaginal ultrasonography.The indexes,pregnancy rates and the value of occult ovarian reserve function before pregnancy were compared among three groups.Results The FSH level in the decrease group was higher than that in the normal group and the increase group(P<0.05);the LH,AMH level and AFC number in the decrease group,the normal group and the increase group showed a gradual increase trend(P<0.05);the clinical pregnancy rate in the normal group was 65.63%,which was higher than 38.30%in the increase group and 17.80%in the decrease group,the difference was statistically significant(P<0.05);the sensitivity of the concealed ovarian reserve function before the detection of AMH level was 92.02%and the specificity was 88.27%.Conclusion AMH screening has better effect on the diagnosis of the decrease of ovarian reserve function before pregnancy.It can accurately evaluate the ovarian reserve function,and it is not easy to be affected by other factors.