Lee Jung Ryeol, Kim Seok Hyun, Kim Sun Mie, Jee Byung Chul, Ku Seung-Yup, Suh Chang Suk, Choi Young Min, Kim Jung Gu, Moon Shin Yong
Department of Obstetrics and Gynecology, College of Medicine, Seoul National University, Seoul, Korea.
Fertil Steril. 2008 Apr;89(4):860-7. doi: 10.1016/j.fertnstert.2007.04.010. Epub 2008 Feb 4.
To compare follicular fluid (FF) anti-Müllerian hormone (AMH) and inhibin B concentrations for GnRH agonist (GnRH-a) and GnRH antagonist cycles and to determine the correlations between FF AMH or inhibin B concentrations and controlled ovarian hyperstimulation (COH) outcomes.
Prospective comparative study.
University hospital.
PATIENT(S): Eighty-seven women who underwent COH cycles, either in the GnRH-a long-protocol group (n = 43) or the GnRH antagonist multiple-dose flexible-protocol group (n = 44).
INTERVENTION(S): Follicular fluid was obtained from dominant follicles during oocyte retrieval, and FF AMH, inhibin B, E(2), and P concentrations were measured. Serum levels of AMH and inhibin B also were assessed on the day of oocyte retrieval.
MAIN OUTCOME MEASURE(S): Follicular fluid AMH and inhibin B concentrations.
RESULT(S): Concentrations of serum AMH and inhibin B and of FF AMH, inhibin B, E(2), and P were similar in the two groups. Follicular fluid AMH levels were found to be significantly correlated with age, gonadotropin dose, number of follicles on hCG day, and number of oocytes retrieved.
CONCLUSION(S): Our results suggest that there is no significant difference in follicular microenvironment in terms of AMH and inhibin B secretion between GnRH-a and GnRH antagonist protocols and that FF AMH is a marker that reflects ovarian reserve and response to COH.
比较促性腺激素释放激素激动剂(GnRH-a)方案和促性腺激素释放激素拮抗剂方案中卵泡液(FF)抗苗勒管激素(AMH)和抑制素B的浓度,并确定FF AMH或抑制素B浓度与控制性卵巢刺激(COH)结果之间的相关性。
前瞻性比较研究。
大学医院。
87例行COH周期的女性,分为GnRH-a长方案组(n = 43)或GnRH拮抗剂多剂量灵活方案组(n = 44)。
在取卵时从优势卵泡获取卵泡液,检测FF AMH、抑制素B、E(2)和P的浓度。在取卵日还评估血清AMH和抑制素B水平。
卵泡液AMH和抑制素B浓度。
两组血清AMH和抑制素B以及FF AMH、抑制素B、E(2)和P的浓度相似。发现卵泡液AMH水平与年龄、促性腺激素剂量、hCG日卵泡数和取卵数显著相关。
我们的结果表明,GnRH-a方案和GnRH拮抗剂方案在AMH和抑制素B分泌方面的卵泡微环境无显著差异,且FF AMH是反映卵巢储备和对COH反应的标志物。