The Center for Human Reproduction (CHR), New York and Foundation for Reproductive Medicine, New York, NY, USA.
Reprod Biol Endocrinol. 2010 Jun 17;8:64. doi: 10.1186/1477-7827-8-64.
Follicle stimulating hormone (FSH) and anti-Müllerian hormone (AMH) represent the two most frequently utilized laboratory tests in determining ovarian reserve (OR). This study determined the clinical significance of their concordance and discordance in female infertility patients.
We investigated 366 consecutive infertility patients (350 reached IVF), excluding women with polycystic ovarian syndrome (PCOS). They were considered to have normal FSH and AMH if values fell within age-specific (as-) 95% confidence intervals (CI), and to suffer from diminished ovarian reserve (DOR) if FSH exceeded and/or AMH fell below those. The two hormones, thus, could be concordant (Group I), both normal (IA) or abnormal (IB), show normal AMH/abnormal FSH (Group II) or normal FSH/abnormal AMH (Group III). Oocyte yields, stratified for age categories, were then studied in each group as reflection of OR.
Oocyte yields significantly decreased from groups IA to II to III and IB. Predictive values of as-FSH/AMH patterns changed, however, at different ages. Except at very young and very old ages, normal as-AMH better predicted higher oocytes yields than normal as-FSH, though above age 42 years normal as-FSH predicts good oocyte yields even with abnormally low AMH. Under age 42 discrepancies between as- FSH and as-AMH remain similarly predictive of oocyte yields at all ages.
Concordances and discordances between as-FSH and as-AMH improve OR assessments and predictability of oocyte yields in IVF.
卵泡刺激素（FSH）和抗苗勒管激素（AMH）是评估卵巢储备功能（OR）最常用的两种实验室检测方法。本研究旨在确定这两种方法在女性不孕患者中的一致性和不协调性的临床意义。
我们研究了 366 例连续不孕患者（350 例进入 IVF 周期），排除了多囊卵巢综合征（PCOS）患者。如果 FSH 和 AMH 值在特定年龄的 95%置信区间（CI）内，则认为它们处于正常范围，而如果 FSH 升高且/或 AMH 降低，则认为存在卵巢储备功能减退（DOR）。因此，这两种激素可以是一致的（I 组），均正常（IA）或异常（IB），表现为正常 AMH/异常 FSH（II 组）或正常 FSH/异常 AMH（III 组）。然后，根据年龄对各组的卵母细胞数量进行分层研究，以反映 OR。
卵母细胞数量从 IA 组到 II 组再到 III 组和 IB 组显著减少。然而，预测价值随着年龄的变化而改变。除了非常年轻和非常年长的年龄组外，正常的 as-FSH/AMH 模式比正常的 as-FSH 更能预测更高的卵母细胞数量，尽管在 42 岁以上，即使 AMH 异常低，正常的 as-FSH 也能预测良好的卵母细胞数量。在 42 岁以下，as-FSH 和 as-AMH 之间的差异在所有年龄段都具有相似的预测卵母细胞数量的能力。
as-FSH 和 as-AMH 的一致性和不协调性提高了 OR 评估和 IVF 中卵母细胞数量的预测能力。
