Jamil Zehra, Fatima Syeda Sadia, Rehman Rehana, Alam Faiza, Arif Sara
Zehra Jamil, Department of Biological & Biomedical Sciences, Aga Khan University, Karachi, Pakistan.
Syeda Sadia Fatima, Department of Biological & Biomedical Sciences, Aga Khan University, Karachi, Pakistan.
Pak J Med Sci. 2016 Jul-Aug;32(4):944-9. doi: 10.12669/pjms.324.10267.
Anti Mullerian hormone (AMH) is gaining place as ovarian marker, chiefly in infertility assistance. We explored its correlation with oocytes retrieval after long GnRH agonist protocol for stimulation, in younger and older infertile population.
This retrospective analysis compiled data of 166 females, receiving ICSI treatment from June 2014 to March 2015. Serum FSH, LH, Estadiol, AMH and antral follicle count were assessed. Outcomes were measured as good (5 to 19 oocytes) and bad responders.
Higher discriminatory power of AMH (AUROC; 0.771; p < 0.05) was seen in comparison to FSH (0.692; p < 0.05) and AFC (0.690; p < 0.01). AMH reported strongest association with oocyte retrieved (odds ratio of 15.06). Subgroup analysis reported 68.6 % risk of bad response with AMH levels of less than 1.37ng/ml. This association was observed more significant in young infertile patients <35 year of age (r=0.245; p=0.012) versus older population >35 year (r=0.169; p>0.05).
Our study reaffirms that serum AMH correlates well with oocytes retrieved, particularly in females younger than 35 years. We suggest incorporation of AMH in baseline assessment of infertile females, who are falsely advised to postpone interventions based on their age and normal FSH levels.
抗苗勒管激素（AMH）作为一种卵巢标志物正逐渐受到重视，主要用于辅助不孕症治疗。我们探讨了其与年轻及年长不孕人群在接受长效促性腺激素释放激素激动剂方案刺激后取卵情况的相关性。
这项回顾性分析收集了2014年6月至2015年3月期间接受卵胞浆内单精子注射（ICSI）治疗的166名女性的数据。评估了血清促卵泡生成素（FSH）、促黄体生成素（LH）、雌二醇、AMH和窦卵泡计数。结局指标分为良好反应者（获卵5至19枚）和反应不良者。
与FSH（0.692；p<0.05）和窦卵泡计数（AFC，0.690；p<0.01）相比，AMH具有更高的鉴别能力（曲线下面积[AUC]；0.77；p<0.05）。AMH与获卵数量的相关性最强（优势比为15.06）。亚组分析显示，AMH水平低于1.37ng/ml时，反应不良的风险为68.6%。在年龄小于35岁的年轻不孕患者中，这种相关性更为显著（r=0.245；p=0.012），而在年龄大于35岁的年长人群中则不显著（r=0.169；p>0.）。
我们的研究再次证实，血清AMH与取卵数量密切相关，尤其是在35岁以下的女性中。我们建议在不孕女性的基线评估中纳入AMH检测，这些女性常因年龄和FSH水平正常而被错误地建议推迟干预措施。
