COH过程中不同时段血清及卵泡液内AMH水平与获卵数的相关性

The Correlation between AMH Levels in Serum and Follicular Fluid and the Number of Retrieved Oocytes During COH

目的研究控制性超促排卵(COH)过程中血清AMH的动态变化、大中卵泡液中AMH水平与获卵数的相关性。方法检测自然月经周期2~4 d基线(BL)、卵泡刺激第6天(S6)及扳机日(Trigger)血清中AMH值;检测大、中卵泡液中AMH值。分析血清AMH的动态变化,及其与获卵数的关系。比较大、中卵泡液中AMH水平与获卵数的关系。结果(1)血清AMH与获卵数呈正相关,BL与trigger、S6与trigger血清AMH有显著性差异P<0.05;(2)大卵泡液AMH值与获卵数呈正相关,大、中卵泡液AMH差异有统计学意义P<0.05;(3)AMH值从BL到S6呈缓慢上升,获卵数越多上升越明显;从S6到trigger日AMH值快速下降,获卵越多下降越明显。结论COH过程中,血清AMH呈波动变化,动态监测AMH值可预测获卵数;对Gn量的调整可能存在一定的指导意义。

Objective To study the dynamic changes of serum AMH during different periods of treatment in patients who received the treatment of controlled ovarian hyperstimulation(COH)and to observe the correlation between AMH level in large and medium follicular fluid and the number of retrieved oocytes.Methods Serum AMH levels were measured on days 2-4 of natural menstrual cycle of baseline(BL),day 6 of follicular stimulation(S6)and day trigger.The AMH levels in the fluid of large and medium follicles were detected.The dynamic changes of serum AMH and its relationship with the number of retrieved oocytes were analyzed.The relationship between the level of AMH and the number of retrieved oocytes was compared between large and medium follicular fluid.Results(1)There was a positive correlation between serum AMH and the number of retrieved oocytes.There was a significant difference in serum AMH between BL and trigger,S6 and trigger(P<0.05);(2)The value of AMH in large follicular fluid was positively correlated with the number of retrieved oocytes,and there was significant difference between large and medium follicular fluid(P<0.05);(3)The value of AMH increased slowly from BL to S6,and the more the number of retrieved eggs,the more obvious the increase;The AMH value decreased rapidly from S6 to trigger day,and the more oocytes were retrieved,the more obvious the decrease was.Conclusion Serum AMH fluctuates during COH,and dynamic monitoring of AMH can predict the number of retrieved oocytes;There may be some guiding significance for the adjustment of Gn.