Department of Obstetrics & Gynecology, Bagcilar Education and Research Hospital, Istanbul, Turkey.
Curr Opin Obstet Gynecol. 2012 Jun;24(3):151-7. doi: 10.1097/GCO.0b013e3283527dcf.
Over the past decade, a large number of studies examining the multiple roles of anti-Müllerian hormone (AMH) have been published. The purpose of this article is to focus on the clinical usefulness of AMH in the fields of current gynecological clinical practice.
AMH has entered clinical practice in terms of poor ovarian response definition. It prevents folliculogenesis by reducing follicle sensitivity to follicle-stimulating hormone (FSH), and leads to anovulation when secreted in excess amounts in polycystic ovary syndrome (PCOS). Better results might be obtained in the assisted reproductive technique cycle in the presence of high AMH levels even though FSH is increased in women diagnosed with diminished ovarian reserve. In a more recently published study it has been reported that AMH can also predict the outcome of pregnancy in assisted reproduction.
AMH levels accurately reflect the ovarian follicular reserve and might, therefore, be considered as a sensitive marker of ovarian aging and ovarian reserve. Evaluation of the level of AMH has clinical value in predicting the success of in-vitro fertilization (IVF). Hyper-response/ovarian hyperstimulation syndrome (OHSS) might be anticipated as about 3.5 ng/ml or above. The cycle stability and operator independency make AMH a most appealing single marker of ovarian reserve. Use of AMH to paint tailored stimulation protocol could result in a reduced risk of OHSS, optimized treatment burden and maintained pregnancy rates. Cost-effectiveness of the use of AMH as a single test before initiating an IVF program should be determined.
在过去的十年中，已经发表了大量研究抗苗勒管激素（AMH）多种作用的文章。本文的目的是重点关注 AMH 在当前妇科临床实践领域的临床应用价值。
AMH 在卵巢反应不良的定义方面已经进入临床实践。它通过降低卵泡对卵泡刺激素（FSH）的敏感性来阻止卵泡发生，并在多囊卵巢综合征（PCOS）中分泌过多时导致无排卵。在患有卵巢储备功能减退的女性中，即使 FSH 升高，高 AMH 水平也可能在辅助生殖技术周期中获得更好的结果。最近的一项研究报告称，AMH 还可以预测辅助生殖的妊娠结局。
AMH 水平准确反映了卵巢卵泡储备，因此可以被认为是卵巢衰老和卵巢储备的敏感标志物。评估 AMH 水平在预测体外受精（IVF）成功方面具有临床价值。高反应/卵巢过度刺激综合征（OHSS）可能会在约 3.5ng/ml 或更高时出现。周期稳定性和操作者独立性使 AMH 成为最具吸引力的单一卵巢储备标志物。使用 AMH 制定量身定制的刺激方案可以降低 OHSS 的风险、优化治疗负担并维持妊娠率。应确定在启动 IVF 计划之前使用 AMH 作为单一测试的成本效益。
