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不同抗苗勒管激素(AMH)检测方法在预测妊娠方面的临床应用。

Clinical utility of different anti-Müllerian hormone - AMH assays for the purpose of pregnancy prediction.

作者信息

Liss Joanna, Kunicki Michal, Czyzyk Adam, Pastuszek Ewa, Zabielska Judyta, Meczekalski Blazej, Lukaszuk Krzysztof

机构信息

a INVICTA Fertility and Reproductive Center , Gdansk , Poland.

c INVICTA Fertility and Reproductive Center , Warsaw , Poland.

出版信息

Gynecol Endocrinol. 2017 Oct;33(10):791-796. doi: 10.1080/09513590.2017.1318370. Epub 2017 Apr 27.

Abstract

PURPOSE

Comparison of outcomes of IVF cycles where the AMH levels was measured with five different AMH kits: Immunotech (IOT), Beckman Coulter II Gen. RUO, Beckman Coulter II Gen. IVD (BC II IVD), Ansh Labs ultrasensitive (Ansh) and the automated Elecsys Roche assay.

METHODS

Retrospective analysis of clinical data for 3693 cycles.

RESULTS

In women < 35 years with low (<0.6 ng/ml) and high (>1.4 ng/ml) AMH concentrations, and in those > 39 years with medium (≥0.6 and ≤1.4 ng/ml) and high AMH concentrations the clinical pregnancy rate differed significantly among groups of patients whose AMH level was measured with different kits. In those subgroups, the highest rates were recorded for the BC II IVD and Ansh groups, while the lowest in the IOT group. AMH concentrations differed significantly between different kits in all age groups (the highest in each age group was for the IOT kit and the lowest for BC II IVD). AMH correlates positively with antral follicle count, MII and number of oocytes retrieved.

CONCLUSIONS

This study demonstrated that we could expect very different pregnancy rates with the same AMH results depending on the AMH kit used. That would means, different values of AMH could similarly lead to misleading clinical decisions in IVF.

摘要

目的

比较使用五种不同的抗缪勒氏管激素(AMH)检测试剂盒(免疫技术公司(IOT)、贝克曼库尔特二代通用研究用试剂盒(RUO)、贝克曼库尔特二代通用体外诊断试剂盒(BC II IVD)、安仕实验室超敏试剂盒(Ansh)以及罗氏全自动电化学发光免疫分析试剂盒)检测AMH水平的体外受精(IVF)周期的结果。

方法

对3693个周期的临床数据进行回顾性分析。

结果

在年龄小于35岁、AMH浓度低(<0.6 ng/ml)和高(>1.4 ng/ml)的女性中,以及在年龄大于39岁、AMH浓度中等(≥0.6且≤1.4 ng/ml)和高的女性中,使用不同试剂盒检测AMH水平的患者组之间临床妊娠率存在显著差异。在这些亚组中,BC II IVD组和Ansh组的妊娠率最高,而IOT组最低。在所有年龄组中,不同试剂盒检测的AMH浓度存在显著差异(每个年龄组中IOT试剂盒检测的AMH浓度最高,BC II IVD试剂盒检测的最低)。AMH与窦卵泡计数、成熟卵母细胞(MII)及获取的卵母细胞数量呈正相关。

结论

本研究表明,根据所使用的AMH试剂盒不同,相同的AMH检测结果可能会有截然不同的妊娠率。这意味着,不同的AMH值在IVF中同样可能导致误导性的临床决策。

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