Center for Human Reproduction - New York and Foundation for Reproductive Medicine, New York, NY, USA.
Reprod Biomed Online. 2011 Mar;22(3):284-91. doi: 10.1016/j.rbmo.2010.12.002. Epub 2010 Dec 13.
This study assessed whether age-specific (as-) cutoffs for anti-Müllerian hormone (AMH) have higher specificity in reflecting ovarian reserve than non-age-specific (nas-) AMH values. as-AMH values were defined in 792 consecutive infertility patients by establishing as-quartiles of AMH within five age groups. Oocyte yields were then compared among women with AMH below or above the 25th centile at each age group. AMH continually decreased with advancing female age (P<0.0001) and differed significantly in each of five selected age categories (P<0.001). In 442 women who reached IVF, as-AMH was predictive of lower oocyte yield if below as-25th centile and of higher oocyte yield if above as-75th centile. Combined normal and elevated as-AMH demonstrated 6.4 times (95% CI 3.9-20.6) odds of retrieving more than four oocytes than low as-AMH. Like as-FSH, as-AMH better reflects ovarian reserve than nas-ovarian reserve testing. However, in contrast to as-FSH, as-AMH defines risk for diminished ovarian reserve or high oocyte yields (i.e. ovarian hyperstimulation syndrome) and, therefore, may be a particularly useful ovarian reserve test in younger women in whom diminished ovarian reserved is most frequently overlooked, and who are at highest risk for ovarian hyperstimulation syndrome.
这项研究评估了抗苗勒管激素（AMH）的年龄特异性（as-）截断值是否比非年龄特异性（nas-）AMH 值具有更高的卵巢储备特异性。在 792 名连续的不孕患者中，通过在五个年龄组内建立 AMH 的 as-四分位数来定义 as-AMH 值。然后比较了每个年龄组中 AMH 低于或高于第 25 百分位的女性的卵母细胞产量。随着女性年龄的增长，AMH 持续下降（P<0.0001），并且在五个选定的年龄组中的每一个都有显著差异（P<0.001）。在 442 名达到 IVF 的女性中，如果 as-AMH 低于 as-25 百分位，则预示着卵母细胞产量较低，如果高于 as-75 百分位，则预示着卵母细胞产量较高。联合正常和升高的 as-AMH 显示出 6.4 倍（95%CI 3.9-20.6）的几率可以获得超过四个卵母细胞，而低值 as-AMH 的几率为 1。与 as-FSH 一样，as-AMH 比 nas-卵巢储备测试更能反映卵巢储备。然而，与 as-FSH 不同，as-AMH 定义了卵巢储备减少或高卵母细胞产量的风险（即卵巢过度刺激综合征），因此，在最常被忽视的卵巢储备减少的年轻女性中，以及在卵巢过度刺激综合征风险最高的女性中，它可能是一种特别有用的卵巢储备测试。
