School of Medicine, University of Glasgow, Glasgow, United Kingdom.
Global Biometrics, Ferring Pharmaceuticals, Copenhagen, Denmark.
Fertil Steril. 2015 Apr;103(4):923-930.e1. doi: 10.1016/j.fertnstert.2014.12.114. Epub 2015 Jan 24.
To compare antimüllerian hormone (AMH) and antral follicle count (AFC) as predictors of ovarian response to controlled ovarian stimulation at individual fertility clinics.
Retrospective analysis of individual study center data in two multicenter trials. Centers that provided >10 patients were included in the analysis.
A total of 19 (n = 519 patients) and 18 study centers (n = 686 patients) participating in a long GnRH agonist trial (MERIT) and a GnRH antagonist trial (MEGASET), respectively.
PATIENT(S): Infertile women of good prognosis.
INTERVENTION(S): Long GnRH agonist or GnRH antagonist cycles.
MAIN OUTCOME MEASURE(S): Correlation between AMH and AFC, and oocyte yield by each study center for each trial.
RESULTS(S): Antimüllerian hormone was more strongly correlated with oocyte yield than AFC: r = 0.56 vs. r = 0.28 in the GnRH agonist cohort, and r = 0.55 vs. r = 0.33 in the GnRH antagonist cohort. The correlation was numerically higher for AMH than for AFC at a significantly higher proportion of study centers: 17 (89%) and 15 (83%) centers in the long GnRH agonist and GnRH antagonist trial, respectively. Assessment of the relative capacity of AMH and AFC for predicting oocyte yield demonstrated that AMH dominated the model: AMH, R(2) = 0.29 and 0.23; AFC: R(2) = 0.07 and 0.07; AMH + AFC: R(2) = 0.30 and 0.23 for long GnRH agonist and GnRH antagonist trials, respectively.
CONCLUSIONS(S): Antimüllerian hormone was a stronger predictor of ovarian response to gonadotropin therapy than AFC at the study center level in both randomized trials utilizing GnRH agonist and GnRH antagonist protocols. Antral follicle count provided no added predictive value beyond AMH.
比较抗苗勒管激素（AMH）和窦卵泡计数（AFC）作为个体生育中心控制性卵巢刺激反应预测因子的能力。
在两项多中心试验中对个体研究中心数据进行回顾性分析。纳入了提供>10 名患者的中心进行分析。
共纳入 19 个（n = 519 名患者）和 18 个研究中心（n = 686 名患者），分别参加了一项长 GnRH 激动剂试验（MERIT）和一项 GnRH 拮抗剂试验（MEGASET）。
预后良好的不孕女性。
长 GnRH 激动剂或 GnRH 拮抗剂周期。
每个试验中每个研究中心的 AMH 和 AFC 与获卵数之间的相关性。
AMH 与获卵数的相关性强于 AFC：长 GnRH 激动剂队列中 r = 0.56 比 r = 0.28，GnRH 拮抗剂队列中 r = 0.55 比 r = 0.33。在长 GnRH 激动剂和 GnRH 拮抗剂试验中，AMH 的相关性在更高比例的研究中心中呈数值性升高（分别为 17 个[89%]和 15 个[83%]）。评估 AMH 和 AFC 预测获卵数的相对能力表明，AMH 占主导地位：AMH，R² = 0.29 和 0.23；AFC：R² = 0.07 和 0.07；AMH + AFC：R² = 0.30 和 0.23，分别用于长 GnRH 激动剂和 GnRH 拮抗剂试验。
在两项使用 GnRH 激动剂和 GnRH 拮抗剂方案的随机试验中，AMH 是预测个体生育中心促性腺激素治疗卵巢反应的更强预测因子，优于 AFC。AFC 除 AMH 外无额外预测价值。
