Columbia University College of Physicians and Surgeons, Division of Reproductive Endocrinology and Infertility, Centre for Women's Reproductive Care, 1790 Broadway, New York, NY 10019, USA.
Reprod Biomed Online. 2010 Jan;20(1):42-7. doi: 10.1016/j.rbmo.2009.10.009. Epub 2009 Oct 30.
While the age of a donor is a fundamental factor to the success of donor IVF, no serum markers have been demonstrated to be useful in predicting variability of ovarian response in individual donors. Anti-Müllerian hormone (AMH) has been described as an accurate marker of ovarian response in patients undergoing IVF, but has not been applied to oocyte donors. AMH concentrations from 104 anonymous oocyte donors between the ages of 21-32 years were studied and IVF outcome parameters compared. AMH was correlated with several parameters including the number of oocytes retrieved (r=0.232, P=0.024), the peak oestradiol concentrations (r=0.235, P=0.024) and the need to decrease gonadotrophin dose in order to avoid ovarian hyperstimulation syndrome (r=0.274, P=0.007). Receiver operating curve analysis was able to identify an AMH threshold that rendered about 70% sensitivity and 70% specificity for predicting the need to decrease gonadotrophin dosing. The clinical pregnancy rate was 77% per recipient and was not related to the donors' AMH concentrations. For oocyte donors, measurement of AMH appears most useful for determining gonadotrophin sensitivity in order to mitigate symptoms consistent with ovarian hyperstimulation.
虽然供体的年龄是供体 IVF 成功的一个基本因素,但目前还没有发现任何血清标志物可用于预测个体供体卵巢反应的变异性。抗苗勒管激素 (AMH) 已被描述为预测接受 IVF 治疗的患者卵巢反应的准确标志物,但尚未应用于卵母细胞供体。研究了 104 名年龄在 21-32 岁之间的匿名卵母细胞供体的 AMH 浓度,并比较了 IVF 结局参数。AMH 与多个参数相关,包括可获得的卵母细胞数量(r=0.232,P=0.024)、雌二醇峰值浓度(r=0.235,P=0.024)以及为避免卵巢过度刺激综合征而需要减少促性腺激素剂量(r=0.274,P=0.007)。接收者操作特征曲线分析能够确定 AMH 阈值,该阈值对预测需要减少促性腺激素剂量的敏感性约为 70%,特异性约为 70%。每个受者的临床妊娠率为 77%,与供体的 AMH 浓度无关。对于卵母细胞供体,AMH 的测量似乎最有助于确定促性腺激素的敏感性,以减轻与卵巢过度刺激一致的症状。