Bas-Lando Maayan, Rabinowitz Ron, Farkash Rivka, Algur Nurit, Rubinstein Esther, Schonberger Oshrat, Eldar-Geva Talia
a Department of Obstetrics & Gynecology , Shaare Zedek Medical Center, Affiliated with the Hebrew University Hadassah School of Medicine , Jerusalem , Israel.
Gynecol Endocrinol. 2017 Oct;33(10):797-800. doi: 10.1080/09513590.2017.1320376. Epub 2017 Apr 28.
Use of hormone contraceptives (HC) is very popular in the reproductive age and, therefore, evaluation of ovarian reserve would be a useful tool to accurately evaluate the reproductive potential in HC users. We conducted a retrospective cohort study of 41 HC users compared to 57 non-HC users undergoing IVF-preimplantation genetic diagnosis (PGD) aiming to evaluate the effect of HC on the levels of anti-Mullerian hormone (AMH), small (2-5 mm), large (6-10 mm) and total antral follicle count (AFC) and the ability of these markers to predict IVF outcome. Significant differences in large AFC (p = 0.04) and ovarian volume (p < 0.0001) were seen, however, there were no significant differences in small and total AFC or in serum AMH and FSH levels. Oocyte number significantly correlated with AMH and total AFC in HC users (p < 0.001) while in non-HC users these correlations were weaker. In HC users, the significant predictors of achieving <6 and >18 oocytes were AFC (ROC-AUC; 0.958, p = 0.001 and 0.883, p = 0.001) and AMH (ROC-AUC-0.858, p = 0.01 and 0.878, p = 0.001), respectively. The predictive values were less significant in non-HC users. These findings are important in women treated for PGD, in ovum donors and for assessing the fertility prognosis in women using HC and wishing to postpone pregnancy.
激素避孕法(HC)在育龄期女性中非常普遍,因此,评估卵巢储备功能将成为准确评估使用HC女性生殖潜能的一项有用工具。我们进行了一项回顾性队列研究,将41名使用HC的女性与57名接受体外受精-胚胎植入前遗传学诊断(PGD)的非HC使用者进行比较,旨在评估HC对抗苗勒管激素(AMH)水平、小卵泡(2-5毫米)、大卵泡(6-10毫米)及窦卵泡总数(AFC)的影响,以及这些指标预测体外受精结局的能力。研究发现,大卵泡AFC(p = 0.04)和卵巢体积(p < 0.0001)存在显著差异,然而,小卵泡AFC、窦卵泡总数、血清AMH和促卵泡生成素(FSH)水平并无显著差异。在使用HC的女性中,卵母细胞数量与AMH和窦卵泡总数显著相关(p < 0.001),而在非HC使用者中,这些相关性较弱。在使用HC的女性中,获得<6个和>18个卵母细胞的显著预测指标分别为AFC(ROC-AUC;0.958,p = 0.001和0.883,p = 0.001)和AMH(ROC-AUC-0.858,p = 0.01和0.878,p = 0.001)。在非HC使用者中,预测价值则不太显著。这些研究结果对于接受PGD治疗的女性、卵子捐赠者以及评估使用HC且希望推迟怀孕的女性的生育预后具有重要意义。