Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Gynecol Endocrinol. 2013 Jan;29(1):6-9. doi: 10.3109/09513590.2012.705372. Epub 2012 Jul 25.
To demonstrate the changes of ovarian aging markers across the Stages of Reproductive Aging Workshop (STRAW) stages and modify it with subclassification of mid reproductive age stage (MR).
Healthy females were classified according to the STRAW system. Serum basal FSH, LH, E2, and anti-Müllerian hormone (AMH) were detected, FSH/LH ratio calculated, and antral follicle counts (AFCs) determined in follicular phase.
Progression through the whole STRAW stages under MR stage subdivided is associated with elevations in FSH, LH, FSH/LH ratio and decreases in E2, AMH and AFCs (p < 0.001). Both serum AMH and AFCs decreased early (after 25 years) and significantly (p < 0.01) with chronological age in MR stage. 0.982 ng/ml AMH and 3 antral follicles (low level of MR 25-30 years) were set as cutoffs to distinguish MR stage into early mid reproductive age (EMR) and late mid reproductive age (LMR) stages. The women in EMR stage compared with LMR could retrieve more oocytes in IVF treatment (p < 0.05) and has a higher pregnancy chance (57.9%) though not significant.
CONCLUSION(S): The early and marked fall in serum AMH levels and AFCs suggest fine markers to further categorize and define the MR stage, demonstrating disparate reproductive aging period with reduced ovarian reserve in young age across the STRAW stages.
展示卵巢衰老标志物在生殖衰老研讨会（STRAW）阶段的变化，并通过对中年生殖年龄阶段（MR）的细分进行修正。
根据 STRAW 系统对健康女性进行分类。在卵泡期检测血清基础 FSH、LH、E2 和抗苗勒管激素（AMH），计算 FSH/LH 比值，并确定窦卵泡计数（AFC）。
在 MR 阶段细分下，整个 STRAW 阶段的进展与 FSH、LH、FSH/LH 比值的升高以及 E2、AMH 和 AFCs 的降低相关（p<0.001）。血清 AMH 和 AFCs 在 MR 阶段均较早（25 岁后）且明显（p<0.01）随年龄增长而下降。0.982ng/ml AMH 和 3 个窦卵泡（MR 25-30 岁的低水平）被设定为截止值，将 MR 阶段分为早期中年生殖年龄（EMR）和晚期中年生殖年龄（LMR）阶段。与 LMR 相比，EMR 阶段的女性在 IVF 治疗中可以获取更多的卵子（p<0.05），且妊娠机会更高（57.9%），尽管没有显著差异。
血清 AMH 水平和 AFCs 的早期和明显下降提示更精细的标志物，可进一步对 MR 阶段进行分类和定义，表明在 STRAW 阶段，卵巢储备随年龄的增长而减少，生殖衰老期存在差异。
