Das Kinderwunsch Institut Schenk GmbH, Am Sendergrund 11, 8143, Dobl, Austria.
Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zürich, Winterthurerstrasse 190, 8057, Zürich, Switzerland.
J Assist Reprod Genet. 2017 Sep;34(9):1115-1120. doi: 10.1007/s10815-017-0908-4. Epub 2017 Mar 21.
Anti-Mullerian hormone (AMH) is commonly known as the most potent marker for ovarian reserve due to its decline as female age increases. While serum AMH (sAMH) levels have been intensively investigated, there is less data regarding AMH concentrations in follicular fluid (FF), since FF has usually been designated as waste product during oocyte collection in assisted reproductive technologies. This pilot study investigated follicle AMH concentrations (fAMH) of several follicles per ovary, individually collected with the Steiner-Tan needle, and compared them to sAMH concentrations in women undergoing IVF treatment. We hypothesized that there is no difference of fAMH concentrations in individual follicles and that these concentrations resemble the sAMH value of the patient.
Patients were stimulated with a gonadotropin-releasing hormone antagonist ovarian hyperstimulation protocol. On the day of oocyte retrieval, serum samples and FF from all individual follicles from one stimulated IVF cycle were collected and individually analyzed for AMH concentrations.
Intracyclic mean fAMH values (n = 2-14) were significantly correlated to sAHM values (ρ = 0.85, p < 0.001) and showed a trend to be negatively associated with age (ρ = -0.43, p = 0.06). Mean intrapatient fAMH concentrations differed significantly (p < 0.001). Furthermore, significant correlations of sAMH with individual fAMH values of the first five follicles of each patient were observed.
In conclusion, our results clearly showed that individual fAMH concentrations reflected sAMH values and that fAMH concentrations did not significantly differ within one patient. In future studies, it will be interesting to correlate individual fAMH values to the respective embryo development and overall pregnancy outcome in order to improve IVF treatments and to refrain from embryo overproduction.
抗苗勒管激素(AMH)通常被认为是卵巢储备功能的最有力标志物,因为其随着女性年龄的增长而下降。虽然已经对血清 AMH(sAMH)水平进行了深入研究,但关于卵泡液(FF)中 AMH 浓度的数据较少,因为在辅助生殖技术中取卵时,FF 通常被视为废物。这项初步研究调查了每个卵巢中多个卵泡的卵泡 AMH 浓度(fAMH),使用 Steiner-Tan 针单独采集,并将其与接受 IVF 治疗的女性的 sAMH 浓度进行了比较。我们假设单个卵泡中的 fAMH 浓度没有差异,并且这些浓度类似于患者的 sAMH 值。
患者接受促性腺激素释放激素拮抗剂卵巢超刺激方案刺激。在取卵日,收集所有单个卵泡的血清样本和 FF,并分别分析 AMH 浓度。
周期性平均 fAMH 值(n = 2-14)与 sAHM 值显著相关(ρ= 0.85,p < 0.001),并且与年龄呈负相关趋势(ρ= -0.43,p = 0.06)。患者内平均 fAMH 浓度差异有统计学意义(p < 0.001)。此外,还观察到 sAMH 与每位患者前五个卵泡的个体 fAMH 值之间存在显著相关性。
总之,我们的结果清楚地表明,个体 fAMH 浓度反映了 sAMH 值,并且单个患者内的 fAMH 浓度没有显著差异。在未来的研究中,将个体 fAMH 值与各自的胚胎发育和整体妊娠结局相关联将很有趣,以便改进 IVF 治疗并避免胚胎过度产生。