上海交通大学学报（医学版）

›› 2010, Vol. 30 ›› Issue (5): 566-.

• 论著（临床研究） • 上一篇    下一篇

抗苗勒管激素对控制性促排卵卵巢低反应的预测价值

宋 玮, 牛志宏, 陈 骞, 冯 云   

  1. 上海交通大学 医学院瑞金医院生殖医学中心, 上海 200025
  • 出版日期:2010-05-25 发布日期:2010-05-28
  • 通讯作者: 冯 云, 电子信箱: artruijin@yahoo.com.cn。
  • 作者简介:宋 玮（1983—）, 女, 硕士生；电子信箱: amythest1983@163.com。

Value of anti-Müllerian hormone in prediction of poor ovarian response to controlled ovarian stimulation

SONG Wei, NIU Zhi-hong, CHEN Qian, FENG Yun   

  1. Reproduction Center, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200025, China
  • Online:2010-05-25 Published:2010-05-28

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摘要：

目的 评估抗苗勒管激素（AMH）对控制性促排卵卵巢低反应的预测价值。方法 测定54例首次行体外授精（IVF）或卵胞质内单精子显微注射（ICSI）患者的基础卵泡刺激素（bFSH）、基础黄体生成素（bLH）、基础雌二醇（bE2）、双侧卵巢窦卵泡计数（AFC）和血清AMH。通过受试者工作特征（ROC）曲线分析各指标对卵巢低反应的预测价值。结果 11例（20.4%）卵巢反应低下者（获卵数≤5）血清AMH水平低于卵巢正常反应者\[（1.46±0.46）ng/mL vs（2.36±1.12）ng/mL\]，差异有统计学意义（P<0.05)。ROC曲线分析显示，AMH和AFC曲线下面积（AUC）分别为0.774和0.728（P<0.01，P<0.05）；各项基础性激素AUC均<0.5（P>0.05）。当AMH截断值≤1.64 ng/mL时，灵敏度为81.8%，特异度为72.1%；当AFC截断值<6时，灵敏度为63.6%，特异度为76.7%。结论 在控制性促排卵中，血清AMH可作为卵巢对外源性促性腺激素反应不良的预测指标。

关键词: 抗苗勒管激素, 促排卵, 卵巢反应

Abstract:

Objective To evaluate anti-Müllerian hormone (AMH) in prediction of poor ovarian response to controlled ovarian hyperstimulation. Methods The serum levels of basal follicle-stimulating hormone (bFSH), basal luteinizing hormone (bLH), basal estradiol (bE2), bilateral antral follicle count (AFC) and AMH in 54 patients with first cycle of in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) were determined. The values of each parameter in prediction of poor ovarian response were assessed using receiver-operating characteristic (ROC) curves. Results The serum AMH level of 11 patients (20.4%) with poor ovarian response (no more than five oocytes) was significantly lower than that of patients with normal ovarian response [(1.46±0.46) ng/mL vs (2.36±1.12) ng/mL, P<0.05]. ROC curve analysis revealed that area under curve (AUC) was 0.774 for AMH (P<0.01) and 0.728 for AFC (P<0.05), and AUC was less than 0.5 for each basal hormone (P>0.05). The sensitivity and specificity were 81.8% and 72.1%, respectively when the cutoff value of AMH was no higher than 1.64 ng/mL, and the sensitivity and specificity were 63.6% and 76.7%, respectively when the cutoff value of AFC was less than 6. Conclusion Serum AMH may serve as a predictor for poor ovarian response to exogenous gonadotrophin in patients undergoing controlled ovarian hyperstimulation.

Key words: anti-Müllerian hormone, ovarian stimulation, ovarian response