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卵巢储备标志物、抗苗勒管激素和窦卵泡计数在持续性妊娠和流产中的非整倍体标志物作用。

Role of ovarian reserve markers, antimüllerian hormone and antral follicle count, as aneuploidy markers in ongoing pregnancies and miscarriages.

机构信息

Department of Maternal-Fetal Medicine, Institute Gynecology, Obstetrics and Neonatology, Hospital Clínic Barcelona, Catalonia, Spain.

Department of Gynecology and Reproduction, Institute Gynecology, Obstetrics and Neonatology, Hospital Clínic Barcelona, Catalonia, Spain.

出版信息

Fertil Steril. 2015 May;103(5):1221-7.e2. doi: 10.1016/j.fertnstert.2015.02.022. Epub 2015 Mar 18.

Abstract

OBJECTIVE

To assess the role of two ovarian reserve markers, antimüllerian hormone (AMH) and antral follicle count (AFC), as markers of the background risk for fetal trisomy.

DESIGN

Prospective study.

SETTING

Tertiary referral hospital.

PATIENT(S): Assessment was carried out either in ongoing pregnancies or miscarriages in our center.

INTERVENTION(S): AFC was assessed transvaginally during a routine (11-13 weeks) or referral scan. AMH was determined either during the first-trimester maternal serum markers assessment or in cases referred for chorionic villi sampling after the invasive procedure.

MAIN OUTCOME MEASURE(S): AMH reference ranges were constructed according to maternal age, and AMH- and AFC-derived ovarian ages were compared among three different cytogenetic groups (normal karyotype, autosomal trisomies, and other chromosomal anomalies) in both ongoing pregnancies and miscarriages.

RESULT(S): In autosomal trisomies, the median AFC-derived ovarian age was 3-5 years above the median maternal age. No differences were observed between AMH-derived ovarian age and maternal age.

CONCLUSION(S): AFC-derived ovarian biologic age reflects a more precise background risk for fetal aneuploidy that is not observed for AMH-derived age.

摘要

目的

评估两种卵巢储备标志物,抗苗勒管激素(AMH)和窦卵泡计数(AFC),作为胎儿三体性背景风险的标志物。

设计

前瞻性研究。

地点

三级转诊医院。

患者

评估在我们中心进行的持续妊娠或流产中进行。

干预措施

在常规(11-13 周)或转诊扫描期间经阴道评估 AFC。AMH 在孕早期母体血清标志物评估时确定,或在侵入性程序后绒毛取样转诊时确定。

主要观察指标

根据母亲年龄构建 AMH 参考范围,并在持续妊娠和流产中比较三种不同细胞遗传学组(正常核型、常染色体三体和其他染色体异常)中 AMH 和 AFC 衍生的卵巢年龄。

结果

在常染色体三体中,AFC 衍生的卵巢年龄中位数比母亲年龄中位数高 3-5 岁。AMH 衍生的卵巢年龄与母亲年龄之间没有差异。

结论

AFC 衍生的卵巢生物学年龄反映了胎儿非整倍体的更精确背景风险,而 AMH 衍生的年龄则没有观察到这种情况。

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