Clinical Value of Serum Anti-Mullerian Hormone and Inhibin B in Prediction of Ovarian Response in Patients with Polycystic Ovary Syndrome

The present study aimed to investigate the clinical value of serum anti-mullerian hormone(AMH) and inhibin B(INHB) in predicting the ovarian response of patients with polycystic ovary syndrome(PCOS). A total of 120 PCOS patients were enrolled and divided into three groups in terms of the ovarian response: a low-response group(n=36), a normal-response group(n=44), and a high-response group(n=40). The serum AMH and INHB levels were measured by enzyme-linked immunosorbent assay(ELISA). The follicle stimulating hormone(FSH), luteinizing hormone(LH), and estradiol(E2) levels were determined by chemiluminescence microparticle immunoassay. The correlation of the serum AMH and INHB levels with other indicators was analyzed. A receiver operating characteristic(ROC) curve was established to analyze the prediction of ovarian response by AMH and INHB. The results showed that there were significant differences in age, body mass index(BMI), FSH, total gonadotropin-releasing hormone(Gn RH), LH, E2, and antral follicle counts(AFCs) between the groups(P<0.05). The serum AMH and INHB levels were increased significantly with the ovarian response of PCOS patients increasing(P<0.05). The serum AMH and INHB levels were negatively correlated with the age, BMI, FSH level, Gn, and E2 levels(P<0.05). They were positively correlated with the LH levels and AFCs(P<0.05). ROC curve analysis of serum AMH and INHB in prediction of a low ovarian response showed that the area under the ROC curve(AUC) value of the serum AMH level was 0.817, with a cut-off value of 1.29 ng/m L. The sensitivity and specificity were 71.2% and 79.6%, respectively. The AUC value of serum INHB was 0.674, with a cut-off value of 38.65 ng/m L, and the sensitivity and specificity were 50.7% and 74.5%, respectively. ROC curve analysis showed when the serum AMH and INHB levels were used to predict a high ovarian response, the AUC value of the serum AMH level was 0.742, with a cut-off value of 2.84 ng/m L, and the sensitivity and specificity were 72.7% and 65.9%, respectively; the AUC value of the serum INHB level was 0.551 with a cut-off of 45.76 ng/m L, and the sensitivity and specificity were 76.3% and 40.2%, respectively. It was suggested the serum AMH and INHB levels have high clinical value in predicting the ovarian response of PCOS patients.

Anti-Mullerian Hormone and Follicle Counts as Predictors of Superovulatory Response and Embryo Production in Beef Cattle

This study evaluated Anti-Mullerian hormone (AMH) and/or follicle counts as predictors of subsequent superovulatory response and embryo production in 79 beef cows. Before superovulation, 3 to 5 mm follicles presented on the ovaries of donor cows were counted, and blood was collected for measure of serum AMH. Across cows, serum AMH ranged from 0.013 to 0.898 ng/mL, with a mean of 0.293 ng/mL. The distribution of both AMH concentrations and follicle counts were divided into quartiles (AMH Q1 through Q4, with Q1 the lowest and Q4 the highest) for analysis. Donor cows in AMH Q4 had a greater (P < 0.001) number of 3 to 5 mm follicles at the start of superovulation than did donors in either Q1 or Q2. At embryo collection, cows in AMH Q3 and 4 had more (P < 0.001) palpable corpora lutea (CL) than cows in AMH Q1. The mean number of embryos recovered from donor cows in AMH Q4 was greater (P < 0.001) than those recovered from cows in either AMH Q1 or 2, but similar to that of AMH Q3. Analysis indicated that AMH was positively correlated (P < 0.001) with mean follicles (r = 0.458), CL (r = 0.452) and embryos recovered (r = 0.430). Donor cows with higher follicle counts (F Q3 and 4) at the start of superovulation had more (P < 0.001) palpable CL at embryo collection than donor cows in F Q1 or 2. More (P < 0.001) embryos were recovered from cows with the highest follicle counts (F Q4) as compared with cows having lower (F Q1 and 2) follicle counts. Results confirm that relative AMH concentration was positively correlated with number of small antral follicles in the ovaries of cows;both AMH measure and antral follicle counts might be used to predict subsequent superovulatory response in beef cows.

Use of Anti-Mullerian Hormone (AMH) for Testing of Ovarian Reserve: A Survey of Fifteen (15) Fertility Centres in Ghana

Anti-Mullerian Hormone (AMH) is a dimeric glycoprotein with a molecular weight of 140 kD, encoded by a gene on the short arm of chromosome and a member of the transforming growth factor-beta (TGF-β) superfamily. The expression of AMH is markedly different in males and females, both in concentration and temporality. In males, Sertoli cells maintain a high concentration of AMH in utero which peaks shortly after birth and then drops precipitously at puberty. In females, granulosa cells produce very low levels of AMH in utero followed by a transient spike in the neonatal period. Concentrations of the hormone then rise steadily through adolescence to a peak in the mid-twenties and subsequently decline until becoming undetectable in menopause. The study aimed to understand how Clinicians and Clinical Embryologists used anti-mullerian hormone (AMH) test to assess ovarian reserve, direct patient selection and treatment regimens and guide in vitro fertilization (IVF) cycle management in all registered fertility hospitals in a West African country, Ghana. A web-based survey (questionnaire) using google forms was performed to solicit responses from all IVF hospitals that are registered with the Fertility Society of Ghana (FERSOG). This questionnaire consisted of fifteen (15) broader questions, ten (10) of which assessed the clinics’ use of AMH. Responses were screened for quality to verify that only one (1) survey was completed by each IVF centre. The study was conducted during May and June 2020 at the In Vitro Fertilization (IVF) Department of the Airport Women’s Hospital (AWH) in Accra, Ghana. Results are reported as the proportion of IVF cycles represented by a particular answer choice. Survey responses were completed from 15 IVF centres, representing 2504 IVF cycles performed annually. A good majority (73.3%) [1835 IVF cycles] of the respondent IVF hospitals reported to use AMH as a first line test and 93.3% reported it as the best test for evaluating ovarian reserve. Another 66.7% reported that AMH results were extremely relevant to clinical practice. However, in contrast, for predicting live birth rate, 60% reported age as the best predictor in their practice. Overall, our results indicate that AMH is considered a first line test for assessing ovarian reserve and is relevant to the clinical practice of majority of Assisted Reproductive Technologies (ART) providers in Ghana.

Expression of anti-Mullerian hormone receptor on the appendix testis in connection with urological disorders

女内部性器官从 paramesonephric (Mullerian ) 开发管。在男胚胎， Mullerian 管的回归被 anti-Mullerian 荷尔蒙(AMH ) 引起，它在阴囊的降下的过程起一个重要作用。在男性的 Mullerian 管的生理的残余是附录睾丸(在) 。在我们的以前的学习，我们为减少的发生介绍了证据在在有 intraoperative 外科的 cryptorchidism。在这份报告， anti-Mullerian 荷尔蒙受体类型的表示 2 ( AMHR2 )， AMH 的特定的受体，与不同 urological 混乱相关在 AT 上被调查例如脱肠 inguinalis ，扭转在， cysta epididymis ，精索静脉曲张，阴囊积水睾丸和 undescended 睾丸的各种各样的形式。在病人和 AMHR2 的表示的年龄之间的关联也被检验。反向的 transcriptase 聚合酶链反应(RT-PCR ) 和 immunohistochemistry 被用来分别地检测受体的 mRNA 和蛋白质层次。我们证明 AMHR2 在 ATs 被表示。另外，这受体的存在在 mRNA 和蛋白质层次被证明。受体的表示模式与既不检验 urological 混乱也不病人的年龄相关；因此， AT 的功能仍然保持阴暗。

Anti-Mullerian Hormone: Establishing the Ovarian Reserve Range with Age in Rivers State Women, Niger Delta Region of Nigeria

Background: The measurement of circulating anti-Mullerian hormone (AMH) in the plasma of adult women has been used as a tool in the assessment of ovarian reserve. This is based on its ability to reflect the number of growing follicles in the ovaries and knowing the level of AMH in a woman’s blood is generally a good indicator of her ovarian reserve and this can be achieved by making reference to a decision values. Objective: The purpose of this study was to measure the level of this hormone in normal, apparently healthy subjects in Rivers State, Nigeria with respect to age. The percentage of women, at their reproductive age with infertility problems in the state is in the increase and the essence was to establish a reference range for the hormone because of its clinical application in women fertility. Materials/method: A total of one thousand and sixty two apparently healthy women divided into four age groups were recruited for this study;this comprised of 300 each in age group of 20 - 30, 31 - 40, 41 - 50 respectively and 162 in 51 - 60 years age group from May 2014 to June 2017. They were randomly selected after filling a questionnaire form that has the information of age, tribe, last date of menses and whether on medication for any infertility problems. Excluded from the study were subjects identified with different endocrine dysfunction and/or on drugs for different types of anovulatory dysfunction. The Enzyme linked Immunoassay method was used in the measurement of the AMH. Results: The result from the measurement of plasma AMH levels showed a Mean ± SD value of 3.193 ± 0.943, 1.644 ± 0.691, 0.516 ± 0.276 and 0.135 ± 0.081 ng/ml respectively for the 1st, 2nd, 3rd and 4th age groups respectively. The mean value for the AMH decreases with increasing age and was statistically significant at the different age group levels (P &minus;2.250 - 4.136;0.953 - 2.350;0.240 - 0.792 and 0.054 - 0.216 respectively for the age groups. This study summarizes the findings concerning AMH and its role as a marker for the quantitative aspect of ovarian reserve, ovarian aging, as well as ovarian dysfunction in this region of the country.

Relationship of Anti-Mullerian Hormone to Reproductive Traits in Katahdin Ewes Bred in Late Spring or Fall

Anti-Mullerian hormone (AMH) is an endocrine marker for fertility in many species. This study investigated possible correlations between serum AMH concentrations, mean number of lambs born (out-of-season in spring or fall), and estimated breeding values (EBVs) for number of lambs born (NLB), number of lambs weaned (NLW), maternal weaning weight (MWWT), weaning weight (WWT), and maternal index (determined by Sheep Genetics Australia). Blood was collected at breeding from Katahdin ewes between 0.7 and 7 years of age in 2015 (n = 163) for the analysis of serum concentrations of AMH. Anti-Mullerian hormone concentration was either expressed quantitatively or divided into quartiles (AMH Q1 through Q4, with Q1 the lowest and Q4 the highest, pg/ml). Data were analyzed by PROC CORR, GLM or chi-squared using SAS. Mean serum AMH was 182 ± 11 pg/ml and ranged from 0 to 1112 pg/ml. There was no correlation between serum AMH and EBVs for NLB, NLW, MWWT, WWT and the maternal index. Serum AMH concentration was similar in ewes in different age categories (P = 0.157). There was a correlation between EBV for NLB (0.29;P = 0.0002) and NLW (0.19;P = 0.013) with average number of lambs born. Ewes in the lowest AMH quartile (Q1) had a lower mean number of offspring born from spring breeding compared with ewes in other AMH quartiles (Q2, Q3, and Q4;P < 0.05). Further study is needed to determine the effectiveness of using serum AMH for selecting ewes for out-of-season (spring) breeding.

Clinical efficacy of anti-Mullerian hormone inspection in supporting diagnosis for climacteric disorders

The diagnosis of climacteric disorders in gynecology is performed on the basis of symptoms rather than hormonal levels. Generally, the follicle-stimulating hormone (FSH) level increases when the 17β-estradiol (E2) level decreases in menopause. However, the problem of these hormones should be determined by strict timing of sampling, and there are individual specificities of decreases of hormone levels. We considered that anti-Mullerian hormone (AMH) can be measured at any time of the menstrual cycle and that it shows ovary functional decline earlier than FSH/E2, and we examined whether AMH would possibly become a good index for climacteric disorders. The subjects were 163 healthy females and 21 patients with climacteric disorders between 20 and 59 years old. We examined AMH, FSH and E2 at the same time. It is understood that in healthy females, AMH decreases with age and a decline in ovary function occurs at a relatively early age. Patients visiting clinics for climacteric disorders often have normal-range serum FSH/E2 levels, and it is clear that these values could not serve as indices of menopause at these inspections. Upon measurement of AMH in patients with climacteric disorders, most showed less than normal range (< 14 pmol/L), suggesting a decline in ovarian function. In addition, AMH was low in females with climacteric disorders compared with those without them. In conclusion, AMH was suggested as an objective index for climacteric disorders and possibly as a new diagnostic marker.

经阴道超声血流参数联合血清抗苗勒管激素对多囊卵巢综合征不孕症体外受精-胚胎移植妊娠失败的预测价值

目的探讨经阴道超声血流参数联合血清抗苗勒管激素(AMH)对多囊卵巢综合征(PCOS)不孕症体外受精-胚胎移植(IVF-ET)妊娠失败的预测价值。方法选取行IVF-ET的173例PCOS不孕症患者为研究对象,其中脱落12例。根据胚胎移植后第28天阴道B超结果将161例患者分为妊娠失败组(n=96)与妊娠成功组(n=65)。比较2组阻力指数(RI)、搏动指数(PI)、收缩与舒张末期最大血流速度比值(S/D)和血清AMH水平。采用多因素Logistic回归分析法分析PCOS不孕症IVF-ET妊娠失败的影响因素。绘制受试者工作特征(ROC)曲线,分析RI、PI、S/D、血清AMH水平单独及联合评估对PCOS不孕症患者IVF-ET妊娠失败的预测价值。结果妊娠失败组血清AMH水平低于妊娠成功组,血流RI、PI、S/D高于妊娠成功组,差异有统计学意义(P<0.001)。RI(OR=4.688,95%CI:2.878~6.498)、PI(OR=4.332,95%CI:2.277~6.387)、S/D(OR=3.773,95%CI:1.856~5.691)、月经第3天黄体生成素(LH)/促卵泡生成素(FSH)值(OR=2.998,95%CI:1.236~4.760)高是PCOS不孕症IVF-ET妊娠失败的危险因素(P<0.05);月经第3天FSH水平高(OR=0.579,95%CI:0.416~0.806)、血清AMH水平高(OR=0.722,95%CI:0.533~0.911)及人绒毛膜促性腺激素(hCG)日子宫内膜厚(OR=0.632,95%CI:0.421~0.843)是PCOS不孕症IVF-ET妊娠失败的保护因素(P<0.05)。RI、PI、S/D联合血清AMH水平预测PCOS不孕症IVF-ET妊娠失败的灵敏度、特异度、曲线下面积(AUC)分别为95.83%、80.00%、0.933。结论超声血流参数联合AMH对PCOS不孕症IVF-ET妊娠失败具有较好的预测价值。

腹腔镜联合GnRH-a治疗对EMS伴不孕症性激素、CA125水平及妊娠率的影响

目的探讨腹腔镜联合促性腺激素释放激素激动剂(GnRH-a)治疗对子宫内膜异位症(EMS)伴不孕症性激素、糖类抗原125(CA125)水平及妊娠率的影响。方法选择滨州医学院附属医院妇产科在2019年1月至2021年1月收治的98例EMS伴不孕症患者作为观察对象,按随机数表法分为C组和O组,每组各49例。C组采取腹腔镜手术治疗,O组采用腹腔镜联合GnRH-a(亮丙瑞林)治疗。比较两组的性激素水平、血清抗米勒管激素(AMH)和CA125水平、随访6、12个月的妊娠率与复发率。结果治疗后(C组术后3个月,O组持续用药3个月结束后),O组的血清黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E_(2))水平低于C组,差异有统计学意义(P<0.05)。O组的血清AMH水平高于C组,CA125水平低于C组,差异有统计学意义(P<0.05)。随访6个月,两组的妊娠率比较差异无统计学意义(P>0.05);随访12个月,O组的妊娠率高于C组,差异有统计学意义(P<0.05),EMS复发率低于C组,差异有统计学意义(P<0.05)。结论腹腔镜联合GnRH-a显著调节EMS伴不孕症患者的性激素水平,改善病情和卵巢功能,提高其妊娠率并减少疾病复发。

子宫动脉搏动/阻力指数联合血清AMH预测IVF-ET助孕结果

目的:探讨子宫动脉搏动指数(UtA-PI)、子宫动脉阻力指数(UtA-RI)联合抗苗勒管激素(AMH)对体外受精-胚胎移植(IVF-ET)助孕结果的预测价值。方法:选择2020年2月-2022月2月本院确诊并行IVF-ET助孕的165例患者临床资料,根据IVF-ET助孕结果分为临床妊娠组(n=95例)与未妊娠组(n=70例)。分析比较各组UtA-PI、UtA-RI与血清AMH水平及临床一般资料;绘制受试者工作特征曲线(ROC)分析UtA-PI、UtA-RI、AMH水平及对IVF-ET助孕结果的预测价值,采用多因素logistic回归分析IVF-ET助孕结果的影响因素。结果:未妊娠组UtA-PI、UtA-RI均高于临床妊娠组,血清AMH水平低于临床妊娠组(均P<0.05)。ROC曲线分析,预测IVF-ET助孕结果血清AMH的曲线下面积为0.855,截断值5.21ng/ml,敏感度91.4%、特异度68.4%;UtA-PI的曲线下面积为0.795,截断值1.66,敏感度91.4%、特异度55.8%;UtA-RI的曲线下面积为0.832,截断值0.94,敏感度91.4%、特异度62.1%;3者联合的曲线下面积为0.922,敏感度、85.7%特异度86.3%。多因素分析显示,血清AMH、UtA-PI、UtA-RI及移植胚胎数目均为影响IVF-ET助孕结果的因素(P<0.05)。结论:UtA-PI升高、UtA-RI升高及AMH降低与IVF-ET是助孕失败的风险因素,3者对IVF-ET助孕结果有较好预测效果,且联合检测预测价值最佳。

不同AMH水平的PCOS患者卵巢反应性及与体外受精-胚胎移植结局的关系

目的探究不同抗苗勒管激素(AMH)水平的多囊卵巢综合征(PCOS)患者卵巢反应性与体外受精-胚胎移植结局的关系。方法选取88例PCOS患者,均接受体外受精-胚胎移植,均在取卵促排前进行AMH检测,结合AMH检测结果分为高AMH组(34例)与低中AMH组(54例)。两组患者均进行常规生化检查、卵巢反应性评估、体外受精-胚胎移植结局等相关指标统计,并比较妊娠结局。结果高AMH组和低中AMH组在窦卵泡计数、睾酮、基础垂体生成素、促性腺激素(Gn)用量、优胚率比较,差异有统计学意义(P<0.05),两组患者的基础雌二醇、基础卵泡刺激素、Gn天数、扳机日雌二醇、获卵数、优质卵泡数、受精率、临床妊娠率比较,差异无统计学意义(P>0.05)。结论高AMH水平会影响PCOS患者的卵巢反应性,并对体外受精-胚胎移植结局造成一定影响。

IVF/ICSI-ET女性AMH、TSH、FORT水平及预测妊娠结局

目的:探讨不孕症行体外受精或卵母细胞卵胞浆内单精子显微注射-胚胎移植(IVF/ICSI-ET)女性抗苗勒氏管激素(AMH)、促甲状腺激素(TSH)、卵泡输出率(FORT)水平及预测妊娠结局价值。方法:收集2018年1月-2022年6月本院辅助生殖医学中心收治的407例行IVF/ICSI-ET治疗的不孕症患者临床资料,根据IVF/ICSI-ET治疗后妊娠结局分为妊娠组228例和未妊娠组179例。在IVF/ICSI-ET启动前一周期的月经第2 d天检测患者AMH及TSH水平,行阴道超声检查卵泡情况计算FORT,并与获卵数目、卵子成熟率、受精率、优质胚胎率的相关性,以受试者工作特征曲线(ROC)分析预测卵泡发育及妊娠结局价值。结果:妊娠组AMH水平(5.12±1.53 ng/ml)高于未妊娠组(3.66±1.14 ng/ml),TSH水平(2.19±0.60 mU/L)低于未妊娠组(2.87±0.85 mU/L),FORT(90.42±6.28)%高于未妊娠组(81.36±8.53)%(均P<0.05)。AMH与获卵数目、卵子成熟率呈正相关,TSH与获卵数目呈负相关,FORT与获卵数目呈正相关(均P<0.05)。AMH、TSH及FORT预测妊娠结局的曲线下面积分别为0.791、0.744、0.836,灵敏度分别为72.5%、70.3%、86.8%,特异度77.8%、66.7%、69.4%。结论:不孕症女性AMH、TSH、FORT与IVF/ICSI-ET获卵数目、卵子成熟率具有关联,对妊娠结局有一定的预测价值。

Impact of Age on Hormonal Profiles of Sub-Fertile Women Attending Fertility Clinic in Umuahia, Abia State, South Eastern Nigeria

Aim: This study evaluated the impact of age on the hormonal profiles of women diagnosed with infertility in a Fertility Clinic in Abia State, South-East, Nigeria. Methodology: Subjects comprised of 200 females: 150 subjects and 50 controls, aged Result: The means ± SEM of serum anti-Mullerian hormones were 1602.44 ± 54.42 pg/ml (control), 848.06 ± 23.04 pg/ml (group 1), 26.74 ± 1.28 pg/ml (group 2), 10.37 ± 1.26 pg/ml (group 3) values for follicle stimulating hormone in the control subjects was 4.90 ± 0.22 mIU/ml, 12.59 ± 0.79 mIU/ml (group 1), 30.59 ± 1.31 mIU/ml (group 2), and 41.59 ± 1.59 miU/ml (group 3). Similarly, the mean ± SEM of luteinizing hormone of control, group 1, group 2 and group 3 were 5.01 ± 0.22 mIU/ml, 15.02 ± 1.13 mIU/ml, 42.71 ± 1.82 mIU/ml and 58.22 ± 2.62 mIU/ml respectively while for estadiol the values were 63.16 ± 1.95 pg/ml, 94.10 ± 5.56 pg/ml, 58.84 ± 4.01 pg/ml and 36.7 ± 1.59 pg/ml for control, group 1, group 2 and group 3 respectively. The mean ± SEM of FSH/LH ratio for the control and experimental subjects were 0.98 ± 0.01, 0.89 ± 0.02, 0.74 ± 0.03 and 0.75 ± 0.02 for control, group 1, group 2 and group 3 respectively. The comparison of the means showed significant difference (p Conclusion: The evaluation of levels of the hormonal parameters across the age ranges of the population studied shows that women within the control and experimental group 1 (<20 years and 20 - 29 years) have a better chance of achieving pregnancy naturally.

子宫动脉彩超血流频谱参数联合血清β-HCG、AMH 预测FET妊娠结局的临床价值

目的 探讨子宫动脉彩超血流频谱参数联合血清人绒毛膜促性腺激素(β-HCG)、抗缪勒管激素(AMH)预测冻融胚胎移植(FET)妊娠结局的临床价值。方法 选取2018年1月至2020年1月在该院生殖医学中心接受FET的不孕症患者90例,根据临床妊娠结局将入组患者有无妊娠分为妊娠组和无妊娠组,比较两组一般资料,血清β-HCG、AMH检测水平以及子宫动脉彩超血流频谱相关参数,采用受试者工作特征(ROC)曲线分析彩超血流频谱参数联合血清β-HCG、AMH预测FET妊娠结局的临床价值。结果 两组年龄、体质量指数(BMI)、不孕时间、不孕类型、子宫位置和胚胎类型比较,差异均无统计学意义(P>0.05)。妊娠组子宫动脉收缩期峰值流速(PSV)、舒张末期流速(EDV)、收缩期峰值/舒张末期流速(S/D)、阻力指数(RI)、搏动指数(PI)均明显低于无妊娠组(P<0.05);妊娠组血清β-HCG、AMH水平均高于无妊娠组(P<0.05)。血清β-HCG、AMH、PSV、EDV、S/D、RI和PI预测FET不良妊娠结局的曲线下面积(AUC)分别为0.792、0.697、0.680、0.653、0.686、0.766和0.796,β-HCG+AMH+PSV+EDV+S/D+RI+PI预测效能更高(AUC=0.836,95%CI:0.801~0.976,P<0.05)。结论 子宫动脉彩超血流频谱参数联合血清β-HCG、AMH对FET不良妊娠结局有较好的预测价值,临床可通过联合检测及时监测与干预。

血清抗苗勒管激素联合25-羟基维生素D检测对多囊卵巢综合征的临床价值分析

目的分析血清抗苗勒管激素(AMH)联合25-羟基维生素D[25(OH)VD]检测对多囊卵巢综合征(PCOS)的临床价值。方法选取2020年1月至2023年9月本院收治的66例PCOS患者作为实验组,另选择66例因输卵管导致不孕患者作为对照组。检测两组受试者血清性激素[血清卵泡激素(FSH)、黄体生成素(LH)、雌二醇(E_(2))、睾酮(T)、催乳素(PRL)]、糖代谢指标[胰岛素(INS)、空腹胰岛素(FPG)、胰岛素抵抗指数(HOMA-IR)]及体内AMH和25(OH)VD水平,分析25(OH)VD和AMH与PCOS患者血清性激素及糖代谢指标的相关性。结果两组FSH水平比较差异无统计学意义;实验组AMH、LH、E_(2)、T、PRL、INS、FPG、HOMA-IR水平均高于对照组,25(OH)VD水平低于对照组,差异有统计学意义(P<0.05)。多因素分析结果显示,LH、T、INS、HOMA-IR、AMH及25(OH)VD均为预测PCOS的重要因素。PCOS患者血清T、LH、INS、HOMA-IR与AMH呈正相关(r>0,P<0.05),与25(OH)VD呈负相关(r<0,P<0.05)。结论LH、T、INS、HOMA-IR、AMH及25(OH)VD均为预测PCOS的重要因素,PCOS患者血清T、LH、INS、HOMA-IR与AMH呈正相关,与25(OH)VD呈负相关。

抗苗勒氏管激素水平对IVF-ET妊娠结局的预测价值评估

目的评估抗苗勒氏管激素（AMH）水平对于体外受精-胚胎移植（IVF-ET）临床妊娠结局的预测价值。方法选择在本中心行IVF/ICSI治疗的患者150例,按年龄将其分为〈35岁组（n=90）和≥35岁组（n=60）。于月经第2~4d测定患者的血清基础卵泡刺激素（bFSH）和基础AMH（bAMH）水平,同时进行阴道B超窦卵泡计数（AFC）;于患者接受促性腺激素（Gn）刺激卵巢第6天测定血清AMH水平（Gn6AMH）及取卵日测定其卵泡液中AMH水平（FFAMH）。评估各检测指标与IVF-ET临床妊娠结局的相关性,并绘制患者受试工作曲线（ROC）,分析并寻找各检测指标预测IVF-ET临床妊娠结局的临界点。结果患者年龄〈35岁时,卵泡液中AMH水平（FFAMH）与IVF-ET临床妊娠结局有显著正相关性（r=0.468,P〈0.01）,当FFAMH水平≥6.590ng/ml时其预测IVF-ET临床妊娠结局的敏感度为78.8%,特异性为81.6%,曲线下面积ROC-AUC为0.859（P〈0.01）,具有良好的预测价值;患者年龄≥35岁时,各个测定指标与临床妊娠结局均无显著相关性（P〉0.05）。结论对于年轻患者（年龄〈35岁）,卵泡液中AMH水平对IVF-ET临床妊娠结局有较高的预测价值;当患者年龄≥35岁时,AMH水平无法预测其临床妊娠结局。

早发性卵巢功能不全患者外周血Tfh占比、功能相关细胞因子表达变化及其与性激素水平的相关性

目的观察早发性卵巢功能不全(POI)患者外周血滤泡辅助性T细胞(Tfh)占比、功能相关细胞因子表达变化,并分析其与性激素水平的相关性。方法POI患者29例(观察组),同期健康体检者31例(对照组),采用流式细胞术检测全血Tfh占比,免疫印迹实验检测外周血单个核细胞(PBMC)CXCR5、BCL-6蛋白,酶联免疫吸附法检测血清IL-6、IL-21,电化学发光法检测血清促卵泡刺激素(FSH)、促黄体生成素(LH)、泌乳素、孕酮、睾酮、雌二醇(E_(2))、抗缪勒管激素(AMH)水平,Spearman相关分析法分析Tfh、CXCR5蛋白、BCL-6蛋白、IL-6、IL-21与性激素的相关性。结果与对照组比较,观察组全血Tfh占比增加,血清IL-6、IL-21水平升高,PBMC CXCR5、BCL-6蛋白表达升高,血清FSH、LH水平升高,血清E_(2)、AMH水平降低,P均<0.05。全血Tfh占比与血清FSH、LH水平呈正相关(r分别为0.75、0.63,P均<0.05),与血清E_(2)、AMH水平呈负相关(r分别为-0.35、-0.82,P均<0.05);血清IL-6水平与血清FSH、LH水平呈正相关(r分别为0.75、0.62,P均<0.05),与血清E_(2)、AMH水平呈负相关(r分别为-0.47、-0.77,P均<0.05);血清IL-12水平与血清FSH、LH水平呈正相关(r分别为0.68、0.56,P均<0.05),与血清E_(2)、AMH水平呈负相关(r分别为-0.25、-0.73,P均<0.05);PBMC BCL-6蛋白表达与血清FSH、LH水平呈正相关(r分别为0.73、0.60,P均<0.05),与血清E_(2)、AMH水平呈负相关(r分别为-0.27、-0.76,P均<0.05);PBMC CXCR5蛋白表达与血清FSH、LH水平呈正相关(r分别为0.72、0.58,P均<0.05),与血清E_(2)、AMH水平呈负相关(r分别为-0.27、-0.70,P均<0.05)。结论POI患者全血Tfh占比增加,PBMC CXCR5、BCL-6蛋白表达升高,血清IL-6、IL-21、FSH、LH水平升高及E_(2)、AMH水平降低,Tfh及其相关因子与性激素呈正相关或负相关,Tfh及其相关因子可能参与了POI发生过程。

补肾促排卵汤治疗体外受精-胚胎移植助孕的PCOS肾虚证患者的临床研究

目的观察补肾促排卵汤对体外受精-胚胎移植(IVF-ET)助孕的多囊卵巢综合征(PCOS)肾虚证患者的临床疗效及对血清性激素水平的影响。方法入组50例行黄体期长方案IVF-ET助孕的PCOS肾虚证患者,其中治疗组和对照组各25例,治疗组使用补肾促排卵汤及生活指导3个周期后进入黄体期长方案IVF-ET周期,对照组生活指导3个周期后进入黄体期长方案IVF-ET周期。观察治疗组及对照组干预前后血清抗苗勒管激素(AMH)、睾酮(T)、促黄体生成素(LH)、体质量指数(BMI)、痤疮及多毛积分、中医证候积分的变化;比较IVF-ET结束后2组的获卵数、促性腺激素(GN)总量、GN天数、双原核受精(2PN)率、2PN卵裂率、优质胚胎率、中重度卵巢过度刺激综合征(OHSS)发生率、冻胚移植(FET)临床妊娠率以及早期流产率。结果治疗组经过治疗后,血清AMH、T、LH水平较治疗前明显下降,痤疮多毛积分与治疗前比较明显好转,中医证候积分较治疗前明显下降,均有统计学差异(P<0.01)。治疗组GN天数及GN总量低于对照组,治疗组2PN率、卵裂率、优质胚胎率高于对照组,均具有统计学意义(P<0.01)。治疗组OHSS发生率低于对照组,FET临床妊娠率高于对照组,早期流产率低于对照组,有统计学差异(P<0.05)。结论补肾促排卵汤可有效改善PCOS患者基础内分泌激素,改善卵子质量,提高优质胚胎率,提高临床妊娠率及降低流产率,降低GN使用天数及总量,降低OHSS发生率。

基于卵巢颗粒细胞功能探讨调周法治疗卵巢储备功能减退的临床研究

目的:基于卵巢颗粒细胞功能探讨中医药调周法对卵巢储备功能减退(diminished ovarian reserve,DOR)患者体内抗穆勒氏管激素(anti-mullerian hormone,AMH)水平的影响及临床疗效。方法:对60例DOR肾虚证患者给予中医药调周法治疗,观察治疗前后患者血清性激素各项水平[AMH、雌二醇(estradiol,E_(2))、黄体生成素(luteinizing hormone,LH)、卵泡刺激素(follicle stimulating hormone,FSH)]和临床疗效。结果:治疗前后E_(2)、LH、FSH水平比较差异无统计学意义(P>0.05);治疗后AMH水平较治疗前升高(P<0.05),中医证候积分较治疗前减少(P<0.05),总有效率为86.7%(52/60);治疗期间均无明显不良反应。结论:中药调周法通过提高AMH、FSH水平来提升DOR肾虚证患者卵巢储备功能,调整月经周期,增加月经量,改善临床症状。

PCOS患者IVF-ET助孕结局及与血清E2、TPO-Ab、TG-Ab、AMH水平关系

目的:分析多囊卵巢综合征(PCOS)患者体外受精-胚胎移植(IVF-ET)助孕结局及与血清雌二醇(E2)、甲状腺过氧化物酶抗体(TPO-Ab)、甲状腺球蛋白抗体(TG-Ab)、抗苗勒管激素(AMH)水平关系。方法:回顾性收集本院行IVF-ET助孕PCOS患者360例,依据使用人绒毛膜促性腺激素(HCG)日血清E2水平分为高、中、低E2组,依据TPO-Ab与TG-Ab检测结果分为甲状腺自身抗体(ATA)阳性组与阴性组,依据血清AMH水平分为高、中、低组,比较各组助孕结局。结果:E2中水平组受精率(81.7%)及临床妊娠率(56.9%)均高于另外两组(P<0.05),而另外两组无差异(P>0.05);ATA阳性组受精率(72.5%)低于ATA阴性组(79.7%),早期流产率(39.5%)高于ATA阴性组(17.2%)(P<0.05);移植胚胎数与优质胚胎数,低AMH组(1.43±0.20枚、3.07±0.60枚)<中AMH组(1.86±0.24枚、4.25±0.71枚)<高AMH组(2.45±0.25枚、7.52±1.02枚)(P<0.05)。结论:PCOS患者IVF-ET时,合理控制血清E2水平可增加患者受精率与临床妊娠率,ATA阳性可增加早期流产风险,高水平AMH患者可获得更好的移植胚胎及优质胚胎,为妊娠结局提供更佳条件。