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轻度/微小子宫内膜异位症不孕患者抗苗勒管激素水平降低及卵巢卵泡群改变。

Decreased anti-Müllerian hormone and altered ovarian follicular cohort in infertile patients with mild/minimal endometriosis.

作者信息

Lemos Nadiane Albuquerque, Arbo Elisangela, Scalco Renata, Weiler Eduardo, Rosa Virginia, Cunha-Filho João Sabino

机构信息

Department of Obstetrics and Gynecology, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Programa de Pós-graduação em Medicina: Ciências Médicas, Porto Alegre, Brazil.

Department of Obstetrics and Gynecology, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.

出版信息

Fertil Steril. 2008 May;89(5):1064-1068. doi: 10.1016/j.fertnstert.2007.04.048. Epub 2007 Jul 10.

Abstract

OBJECTIVE

To evaluate the ovarian reserve and follicular cohort of infertile patients with minimal/mild endometriosis.

DESIGN

Prospective study.

SETTING

University hospital.

PATIENT(S): Patients were divided into two groups: group I, minimal/mild endometriosis and group II, tubal obstruction. The following exclusion criteria were established: [1] patients with previous endocrine disorders; and [2] cases in which the cause for infertility was other than endometriosis (except for patients with tubal obstruction, in the control group).

INTERVENTION(S): Serum FSH and anti-Müllerian hormone were measured on day 3. On the same day all patients were submitted to transvaginal ultrasound to evaluate the antral follicular count and the ovarian follicular cohort.

MAIN OUTCOME MEASURE(S): Serum FSH, anti-Müllerian hormone, and the follicular cohort with the respective antral follicular count.

RESULT(S): Serum FSH were not different between the groups. However, infertile patients with endometriosis have a decreased serum anti-Müllerian hormone (1.26 +/- 0.7 ng/mL) compared to the control group (2.02 +/- 0.72 ng/mL). The analysis of follicular cohort showed that the number of selectable follicles were similar, but the follicular diameter was different.

CONCLUSION(S): Minimal/mild endometriosis is associated with a decrease in the follicular ovarian reserve. In addition, the follicular cohort of these patients is more heterogeneous in comparison to the control group.

摘要

目的

评估轻度/中度子宫内膜异位症不孕患者的卵巢储备功能和卵泡群。

设计

前瞻性研究。

地点

大学医院。

患者

患者分为两组:第一组,轻度/中度子宫内膜异位症;第二组,输卵管阻塞。确立了以下排除标准:[1]既往有内分泌疾病的患者;[2]不孕原因不是子宫内膜异位症的病例(对照组中输卵管阻塞患者除外)。

干预措施

在第3天测定血清促卵泡激素(FSH)和抗苗勒管激素(AMH)。同一天,所有患者均接受经阴道超声检查,以评估窦卵泡计数和卵巢卵泡群。

主要观察指标

血清FSH、抗苗勒管激素以及相应窦卵泡计数的卵泡群。

结果

两组间血清FSH无差异。然而,与对照组(2.02±0.72 ng/mL)相比,子宫内膜异位症不孕患者的血清抗苗勒管激素降低(1.26±0.7 ng/mL)。卵泡群分析显示可选择卵泡数量相似,但卵泡直径不同。

结论

轻度/中度子宫内膜异位症与卵泡卵巢储备功能下降有关。此外,与对照组相比,这些患者的卵泡群更具异质性。

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