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在进行体外受精时,多囊卵巢女性在卵泡穿刺时获得的卵泡液中,抗苗勒管激素水平升高,促卵泡激素水平降低。

Increased anti-Müllerian hormone and decreased FSH levels in follicular fluid obtained in women with polycystic ovaries at the time of follicle puncture for in vitro fertilization.

机构信息

Department of Endocrine Gynaecology and Reproductive Medicine, Hôpital Jeanne de Flandre, CHRU and Université de Lille II, Lille, France.

出版信息

Fertil Steril. 2010 Jun;94(1):198-204. doi: 10.1016/j.fertnstert.2009.03.004. Epub 2009 Apr 9.

Abstract

OBJECTIVE

To confirm the increased levels of anti-Müllerian hormone (AMH) in preovulatory follicles from patients with polycystic ovary syndrome (PCOS) and to study the role of other hormones involved in folliculogenesis in this increased secretion.

DESIGN

Prospective study.

SETTING

University hospital in France.

PATIENT(S): Twenty-two patients with PCOS and 20 controls undergoing IVF.

INTERVENTION

On the day of oocyte retrieval, follicular fluid (FF) from one small follicle (8-13 mm) (SF) and one large follicle (16-23 mm) (LF) was collected in each patient.

MAIN OUTCOME MEASURE(S): Per-follicle AMH, FSH, estradiol, androstenedione, hCG, and progesterone levels, and pregnancy rate.

RESULT(S): In FF from both SF and LF of PCOS patients, AMH level was significantly increased, and FSH level was significantly decreased when compared with controls. Both hormone levels were negatively and significantly related in controls but not in PCOS. The AMH levels from SF and LF were significantly lower in patients who began a pregnancy.

CONCLUSION(S): Our findings suggest that the granulosa cells from polycystic ovaries continue to produce elevated levels of AMH, possibly because of impaired access of FSH to follicles. Such an excess in FF AMH may have harmful consequences on oocyte quality and final maturation through unknown mechanisms.

摘要

目的

确认多囊卵巢综合征(PCOS)患者的促排卵卵泡中抗苗勒管激素(AMH)水平升高,并研究参与卵泡发生的其他激素在这种过度分泌中的作用。

设计

前瞻性研究。

地点

法国某大学医院。

患者

22 名 PCOS 患者和 20 名接受 IVF 的对照者。

干预措施

在取卵日,从每位患者的一个小卵泡(8-13mm)(SF)和一个大卵泡(16-23mm)(LF)中采集卵泡液(FF)。

主要观察指标

每个卵泡的 AMH、FSH、雌二醇、雄烯二酮、hCG 和孕酮水平,以及妊娠率。

结果

与对照组相比,PCOS 患者的 SF 和 LF 中的 FF 中 AMH 水平显著升高,FSH 水平显著降低。在对照组中,两种激素水平呈负相关且显著相关,但在 PCOS 中无相关性。开始妊娠的患者 SF 和 LF 中的 AMH 水平显著降低。

结论

我们的研究结果表明,多囊卵巢中的颗粒细胞可能由于 FSH 无法进入卵泡而继续产生升高水平的 AMH。这种 FF AMH 的过量可能通过未知机制对卵母细胞质量和最终成熟产生有害影响。

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