Himabindu Y, Sriharibabu M, Gopinathan Kk, Satish Usha, Louis T Fessy, Gopinath Parasuram
Department of Obstetrics and Gynacology, GSL Medical College and General Hospital, Rajahmundry, Andhra Pradesh, India.
J Hum Reprod Sci. 2013 Jan;6(1):27-31. doi: 10.4103/0974-1208.112377.
The objective of this study was to test the hypothesis that AMH and antral follicle count (AFC) are good predictors of ovarian response to controlled ovarian stimulation and to compare them.
This observational cross-sectional study included 56 subjects aged between 25 and 42 years who were enrolled between 1(st) January and 31(st) December 2010 for their first intracytoplasmic sperm injection (ICSI) program. Baseline hormone profiles including serum levels of Estradiol (E2), Follicle-stimulating hormone (FSH), Luteinizing hormone (LH), and Anti-mullerian Hormone (AMH) were determined on day 3 of the previous cycle. The antral follicle count measurements were performed on days 3-5 of the same menstrual cycle. Antral follicles within the bilateral ovaries between 2-6 mm were recorded. The subjects were treated with long protocol for ovarian stimulation. Ovulation was induced with 10,000 IU of human chorionic gonadotropin (hCG) when at least 3 follicles attained the size of more than 17 mm. Transvaginal oocyte retrieval was performed under ultrasound guidance 36 hours after hCG administration. An oocyte count less than 4 and absence of follicular growth with controlled ovarian hyper stimulation was considered as poor ovarian response. Oocyte count of 4 or more was considered as normal ovarian response.
Statistical analysis was performed using SPSS software trail version 16.0. Subjects were divided into 2 groups, depending on the ovarian response. The mean oocyte counts were 12.27 ± 6.06 and 2.22 ± 1.24 in normal and poor responders, respectively, (P = 001). Multiple regression analysis revealed AMH and antral follicle count as predictors of ovarian response (β coefficient ± SE for AMH was 1.618 ± 0.602 (P = 0.01) and for AFC, it was, 0.528 ± 0.175 (P = 0.004). AFC was found to be a better predictor of ovarian response compared to AMH in controlled ovarian hyper stimulation.
The observations made in this study revealed that both AMH and AFC are good predictors of ovarian response; AFC being a better predictor compared to AMH.
本研究的目的是检验抗苗勒管激素（AMH）和窦卵泡计数（AFC）是卵巢对控制性卵巢刺激反应的良好预测指标这一假设，并对它们进行比较。
这项观察性横断面研究纳入了56名年龄在25至42岁之间的受试者，他们于2010年1月1日至12月31日期间参加了首次卵胞浆内单精子注射（ICSI）项目。在前一周期的第3天测定基线激素水平，包括血清雌二醇（E2）、促卵泡激素（FSH）、促黄体生成素（LH）和抗苗勒管激素（AMH）水平。在同一月经周期的第3至5天进行窦卵泡计数测量。记录双侧卵巢内直径在2至6毫米之间的窦卵泡。受试者采用长方案进行卵巢刺激。当至少有3个卵泡直径达到17毫米以上时，用10000国际单位的人绒毛膜促性腺激素（hCG）诱导排卵。在注射hCG 36小时后，在超声引导下经阴道取卵。卵母细胞计数少于4个以及在控制性卵巢过度刺激下卵泡无生长被视为卵巢反应不良。卵母细胞计数为4个或更多被视为正常卵巢反应。
使用SPSS软件试用版16.0进行统计分析。根据卵巢反应将受试者分为两组。正常反应者和反应不良者的平均卵母细胞计数分别为12.27±6.06和2.22±1.24，（P = 0.01）。多元回归分析显示AMH和窦卵泡计数是卵巢反应的预测指标（AMH的β系数±标准误为1.618±0.602（P = 0.01），AFC的β系数±标准误为0.528±0.175（P = 0.004）。在控制性卵巢过度刺激中，发现AFC比AMH是更好的卵巢反应预测指标。
本研究中的观察结果表明，AMH和AFC都是卵巢反应的良好预测指标；与AMH相比，AFC是更好的预测指标。
