生殖医学杂志2012，Vol.21Issue(4)：324-328,5.DOI:10.3969/j.issn.1004-3845.2012.04.005
基础及促性腺激素刺激第6天血清抗苗勒管激素水平对卵巢反应性的预测价值
Value of anti- Müllerian hormone serum concentrations of basal and day 6 after stimulation as predictors of ovarian response
摘要
Abstract
Objective: To investigate the value of serum levels of anti-Miillerian hormone (AMH) at baseline and on day 6 after stimulation in predicting ovarian response during in vitro fertilization and embryo transfer (IVF-ET). Methods; The prospective study enrolled 91 women given by GnRH-a + recombine follicle stimulating hormone (rFSH) + human chorionic gonadotrophin (hCG) long term stimulation protocol during their first cycle of IVF-ET treatment. The patients were divided into three groups including poor response (group A, n = ll) , normal response (group B, w=50) , and over response (group C, n = 30) based on the number of oocytes retrieved and serum levels of E2 on hCG administration day. The serum levels of FSH, estradiol (E2) at baseline, anti-Miillerian hormone (AMH) at baseline and on day 6 after stimulation (D6AMH) , E2 on day 6 after stimulation (D6E2)and on hCG administration day, and the number of antral follicle count (AFC) were assessed. Ovarian response was evaluated by the number of oocytes retrieved. Results: The levels of AMH at baseline and day 6, the number of oocytes retrieved and the levels of E2 on hCG day had statistically significant differences among the three groups ( group C>group B> group A, P<0. 05). The serum levels of AMH at baseline and on day 6 after stimulation were significantly different in all three groups(P<0. 05). Serum levels of AMH 6 days after stimulation were significantly lower than those at baseline (P<0. 05). The number of oocytes retrieved was strongly correlated with the level of D6AMH, D6E2, the level of AMH at baseline and AFC. The results of multiple regression analysis showed that D6AMH was the most important factor in predicting the number of retrieved oocytes. ROC analyses showed that D6AMH had the largest area under curve (AUC) 0. 872 to predict the poor response, when 1. 159 ng/ml was selected as the AMH cut-off value with 90% sensitivity and 84% specificity. To predict the high response, D6AMH had the largest area under curve (AUC) 0. 895, when 3. 22 ng/ml was selected as the AMH cut-off value with 77% sensitivity and 87% specificity. Conclusions: The AMH levels at basal and on day 6 after stimulation were both useful factors in predicting ovarian response and number of retrieved oocytes. The serum levels of AMH on 6 days after stimulation was highly correlated with the number of oocytes retrieved; therefore it could be a better predictor of ovarian response in IVF-ET.关键词
抗苗勒管激素/促性腺激素释放激素激动剂/体外受精-胚胎移植/卵巢反应性Key words
Anti-Mullerian hormone/ Gonadotropin-releasing hormone/ In vitro fertilization and embryo transfer/ Ovarian response引用本文复制引用
杨晓菁,林文琴,余蓉..基础及促性腺激素刺激第6天血清抗苗勒管激素水平对卵巢反应性的预测价值[J].生殖医学杂志,2012,21(4):324-328,5.基金项目
浙江省教育厅项目(Y200804987) （Y200804987）
