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接受体外受精/卵胞浆内单精子注射的多囊卵巢综合征女性体内的抗苗勒管激素和雄激素

Anti-mullerian and androgens hormones in women with polycystic ovary syndrome undergoing IVF/ICSI.

作者信息

Swellam Menha, Khaial Abeer, Mosa Tamer, El-Baz Hatim, Said Mohamed

机构信息

Department of Biochemistry, Genetic Engineering and Biotechnology Research Division, National Research Center, Dokki, Giza, Egypt.

Department of Biochemistry, Genetic Engineering and Biotechnology Research Division, National Research Center, Dokki, Giza, Egypt. ; Department of Biochemistry, El-Gouf University, Kingdom Saudi Arabia.

出版信息

Iran J Reprod Med. 2013 Nov;11(11):883-90.

Abstract

BACKGROUND

Despite its frequency, the polycystic ovary syndrome (PCOS) is still a difficult diagnosis in endocrinology, gynecology, and reproductive medicine. The Rotterdam consensus conference proposed to include the ultrasonographic follicle count as a new diagnostic criterion. Unfortunately, its assessment does not offer sufficient reliability worldwide.

OBJECTIVE

To explore the possible roles of altered circulating androgens and anti-mullerian hormone among PCOS women regarding their body mass index and their outcomes after IVF.

MATERIALS AND METHODS

In this cross sectional study, 195 women with PCO were included, they were divided according to their body mass index (BMI <27 kg/m(2)) as obese PCOS (n=91) and overweight PCOS (BMI ≥27 kg/m(2)) (n=104). Serum levels of androgens (dehydroepiandrosterone sulfate [DHEAS], testosterone and androstenedione [A4]), and anti-mullerian hormone (AMH) were assessed and compared with the endocrine profile and cycles outcomes.

RESULTS

AMH, A4, FSH, and TSH concentrations were significantly higher in obese than in overweight women (p˂0.001). Contrary, LH: FSH ratio values, E2, PRL and DAHE-S levels were significantly lower in obese than in overweight women (p˂0.0001). Total oocyte retrieved, mature and fertilized oocyte were significantly higher in obese than in overweight women. Among pregnant obese PCOS women both AMH and A4 were significantly increased and DAHE-S was significantly decreased compared to pregnant overweight PCOS women.

CONCLUSION

Obese PCOS women have a higher chance of getting pregnant over those categorized as overweight PCOS. Also, androgens and AMH levels recommended to be considered in IVF attributes among obese and overweight PCOS women.

摘要

背景

尽管多囊卵巢综合征(PCOS)很常见,但在内分泌学、妇科和生殖医学领域仍是一个难以诊断的疾病。鹿特丹共识会议提议将超声卵泡计数作为一项新的诊断标准。遗憾的是,在全球范围内其评估的可靠性不足。

目的

探讨循环雄激素和抗苗勒管激素变化在PCOS女性中与其体重指数及体外受精(IVF)结局之间的可能作用。

材料与方法

在这项横断面研究中,纳入了195例患有多囊卵巢(PCO)的女性,根据其体重指数(BMI<27kg/m²)分为肥胖型PCOS(n=91)和超重型PCOS(BMI≥27kg/m²)(n=104)。评估血清雄激素(硫酸脱氢表雄酮[DHEAS]、睾酮和雄烯二酮[A4])以及抗苗勒管激素(AMH)水平,并与内分泌特征和周期结局进行比较。

结果

肥胖女性的AMH、A4、促卵泡生成素(FSH)和促甲状腺激素(TSH)浓度显著高于超重女性(p<0.001)。相反,肥胖女性的促黄体生成素与促卵泡生成素比值、雌二醇(E2)、催乳素(PRL)和DHEA-S水平显著低于超重女性(p<0.0001)。肥胖女性获取的总卵母细胞、成熟卵母细胞和受精卵母细胞显著多于超重女性。与怀孕的超重PCOS女性相比,怀孕的肥胖PCOS女性的AMH和A4均显著升高,而DHEA-S显著降低。

结论

肥胖型PCOS女性比超重型PCOS女性怀孕几率更高。此外,在肥胖和超重PCOS女性的IVF相关因素中,雄激素和AMH水平值得考虑。

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