血清抗苗勒管激素对卵巢功能衰退及体外受精超促排卵中卵巢反应的预测价值

Predictive Value of Serum Anti-Müllerian Hormone on Ovarian Function Decline and Ovarian Response in In Vitro Fertilization and Superovulation

目的探究血清抗苗勒管激素(AMH)对卵巢功能衰退及体外受精(IVF)超促排卵中卵巢反应的预测价值。方法以2020年1月-2022年1月于佳木斯市中心医院接受IVF助孕的60例女性为研究对象,其中卵巢功能衰退者26例、卵巢功能正常者34例,所有研究对象均给予相同超促排卵方案,并依据其获卵数分为卵巢正常反应组(23例)、卵巢低反应组(17例)、卵巢高反应组(20例),比较卵巢功能衰退者与卵巢功能正常者以及不同卵巢反应组的血清AMH水平,并分析其对卵巢功能衰退及IVF超促排卵后卵巢反应的预测价值。结果卵巢功能衰退者的AMH水平低于卵巢功能正常者(P<0.05);经ROC曲线分析显示,AMH预测卵巢功能衰退的AUC为0.805,灵敏度为0.671,特异度为0.792,截点值为2 ng/ml;AMH水平由高到低依次为卵巢高反应组>卵巢正常反应组>卵巢低反应组(P<0.05);经ROC曲线分析显示,AMH预测IVF超促排卵后卵巢低反应的AUC为0.825,灵敏度为0.702,特异度为0.815,截点值为2.51 ng/ml;AMH预测IVF超促排卵后卵巢高反应的AUC为0.796,灵敏度为0.675,特异度为0.641,截点值为4.76 ng/ml。结论血清AMH对卵巢功能衰退及IVF超促排卵后卵巢反应均具有良好预测价值。

Objective To explore the predictive value of serum anti-Müllerian hormone(AMH)on ovarian function decline and ovarian response in in vitro fertilization(IVF)and superovulation.Methods A total of 60 women who received IVF in Jiamusi Central Hospital from January 2020 to January 2022 were selected as the research objects,including 26 patients with ovarian function decline and 34 patients with normal ovarian function.All the subjects were given the same superovulation regimen,and were divided into normal ovarian response group(23 subjects),poor ovarian response group(17 subjects)and high ovarian response group(20 subjects)according to the number of eggs obtained.The serum AMH levels of patients with ovarian function decline,normal ovarian function and different ovarian response groups were compared,and their predictive value for ovarian function decline and ovarian response after IVF superovulation was analyzed.Results The AMH level in patients with ovarian function decline was lower than that in patients with normal ovarian function(P<0.05).The ROC curve analysis showed that the AUC of AMH predicting ovarian function decline was 0.805,the sensitivity was 0.671,the specificity was 0.792,and the cut-off value was 2 ng/ml.The order of AMH level from high to low was ovarian high response group>normal ovarian response group>low ovarian response group(P<0.05).ROC curve analysis showed that the AUC of AMH in predicting poor ovarian response after IVF superovulation was 0.825,the sensitivity was 0.702,the specificity was 0.815,and the cut-off value was 2.51 ng/ml.The AUC of AMH in predicting high ovarian response after IVF superovulation was 0.796,the sensitivity was 0.675,the specificity was 0.641,and the cut-off value was 4.76 ng/ml.Conclusion Serum AMH has a good predictive value for ovarian function decline and ovarian response after IVF superovulation.