Tremellen Kelton, Kolo Michelle
Repromed, Adelaide, South Australia, Australia.
Aust N Z J Obstet Gynaecol. 2010 Dec;50(6):568-72. doi: 10.1111/j.1479-828X.2010.01232.x. Epub 2010 Sep 20.
Serum anti-Mullerian hormone (AMH) is an established marker of the number of oocytes left within a woman's ovaries (quantitative ovarian reserve). However, it is presently unclear if serum AMH also measures oocyte quality and therefore the chances of successful live-birth pregnancy. The aim of this study was to determine if serum AMH assessed ovarian reserve correlates with chances of live birth (LB) and miscarriage following intra-uterine insemination (IUI) treatment.
In this retrospective study, serum AMH percentile charts were developed using AMH measurements from 1032 women undergoing routine infertility investigation. A total of 244 women undergoing IUI treatments were classified according to whether they had low (first quartile), normal (second and third quartiles) or high (fourth quartile) serum AMH concentrations relative to their age, and the subsequent pregnancy outcomes were analysed.
Serum AMH concentration fell with advancing maternal age and serum AMH concentrations were well correlated with quantitative ovarian reserve (antral follicle counts, AFC). The LB and miscarriage rates in each of the four AMH quartiles did not differ significantly from one another.
Serum AMH is a useful marker of quantitative but not qualitative ovarian reserve as it correlates well with AFC, yet bears no relation to chances of live-birth or miscarriage.
血清抗苗勒管激素（AMH）是女性卵巢内剩余卵母细胞数量（定量卵巢储备）的既定标志物。然而，目前尚不清楚血清AMH是否也能衡量卵母细胞质量，进而衡量活产妊娠成功的几率。本研究的目的是确定评估卵巢储备的血清AMH是否与宫内人工授精（IUI）治疗后的活产（LB）几率和流产相关。
在这项回顾性研究中，使用1032名接受常规不孕症检查的女性的AMH测量值绘制血清AMH百分位数图表。根据血清AMH浓度相对于其年龄处于低（第一四分位数）、正常（第二和第三四分位数）或高（第四四分位数），将总共244名接受IUI治疗的女性进行分类，并分析随后的妊娠结局。
血清AMH浓度随着母亲年龄的增长而下降，且血清AMH浓度与定量卵巢储备（窦卵泡计数，AFC）密切相关。四个AMH四分位数中每个四分位数的LB率和流产率彼此之间无显著差异。
血清AMH是定量而非定性卵巢储备的有用标志物，因为它与AFC密切相关，但与活产几率或流产无关。
