Tremellen Kelton P, Kolo Michele, Gilmore Alan, Lekamge Dharmawijaya N
Reproductive Medicine Laboratories, South Australia.
Aust N Z J Obstet Gynaecol. 2005 Feb;45(1):20-4. doi: 10.1111/j.1479-828X.2005.00332.x.
To analyse the usefulness of plasma anti-mullerian hormone (AMH) measurement as a tool for assessing ovarian reserve in a general infertility population.
Plasma AMH levels were analysed in 238 women aged 18-46 years during day 3-5 of their menstrual cycle. All 238 patients had follicle stimulating hormone (FSH) levels less than 10 i.u./L, suggesting normal ovarian reserve on traditional FSH criteria. Eighty-seven patients gave their consent to correlate their AMH levels with IVF oocyte retrieval outcome. Patients producing > or = 8 oocytes were classified as having normal ovarian reserve, while those producing < or = 4 oocytes were classified as having poor ovarian reserve.
Plasma AMH levels remained relatively static (20-25 pmol/L) from 18 to 29 years of age. By 30 years of age, plasma AMH levels start to drop rapidly, reaching only 10 pmol/L by 37 years. Despite this 50% fall in AMH levels between 29 and 37 years of age, minimal changes in FSH levels were observed. Using a cut off value of 8.1 pmol/L, plasma AMH assessment could predict poor ovarian reserve on a subsequent IVF cycle with a sensitivity of 80% and a specificity of 85%.
Plasma AMH assessments are superior to FSH in identifying women with reduced ovarian reserve. Anti-mullerian hormone assessment should be considered as a useful adjunct to FSH/oestradiol levels and antral follicle count when estimating ovarian reserve.
分析血浆抗苗勒管激素（AMH）检测作为评估一般不孕症人群卵巢储备功能工具的实用性。
对238名年龄在18 - 46岁的女性在月经周期第3 - 5天的血浆AMH水平进行分析。所有238例患者的促卵泡激素（FSH）水平均低于10国际单位/升，按照传统FSH标准提示卵巢储备功能正常。87例患者同意将其AMH水平与体外受精（IVF）取卵结果相关联。产生≥8个卵母细胞的患者被归类为卵巢储备功能正常，而产生≤4个卵母细胞的患者被归类为卵巢储备功能差。
18至29岁时血浆AMH水平相对稳定（20 - 25皮摩尔/升）。到30岁时，血浆AMH水平开始迅速下降，到37岁时仅为10皮摩尔/升。尽管在29至37岁之间AMH水平下降了50%，但FSH水平的变化却微乎其微。采用8.1皮摩尔/升的临界值，血浆AMH检测能够预测后续IVF周期中卵巢储备功能差，灵敏度为80%，特异性为85%。
在识别卵巢储备功能降低的女性方面，血浆AMH检测优于FSH检测。在评估卵巢储备功能时，抗苗勒管激素检测应被视为FSH/雌二醇水平及窦卵泡计数的有用辅助手段。
