Department of Obstetrics and Gynecology, Bahcesehir University School of Medicine, Istanbul, Turkey.
Eur Rev Med Pharmacol Sci. 2017 May;21(10):2499-2503.
To assess the clinical value of antral follicle count (AFC) and anti-Mullerian hormone (AMH) for the prediction of ovarian response in women with endometrioma undergoing controlled ovarian stimulation for IVF using GnRH antagonist treatment.
Fifty patients with endometrioma who underwent their first IVF/ICSI cycle with GnRH antagonist treatment were included in the study. The average AMH values were recorded as 1.5-2 ng/mL. Fifty infertile women are not suffering from endometrioma were selected from those with male factor infertility as control. They were matched according to both serum AMH levels and age. Serum samples have been collected before the IVF treatment for determining AMH levels in both groups of subjects. Likewise, each group of subject underwent ultrasound scan for AFC on day 3. Total number of oocytes retrieved during OPU, the number of transferred embryo, implantation and clinical pregnancy rates, live birth and abortion rates, total dose of rhFSH were noted in both groups of subjects.
Day 3 AFC was significantly higher in the control group compared to women with endometrioma. Both the number of retrieved oocytes during oocyte pick-up, MII oocytes and 2 PN embryo were significantly lower in the endometrioma. Likewise, the fertilization, implantation, clinical pregnancy and live birth rates of endometrioma group were significantly lower than those in the control group. The total rFSH dose was higher in the endometrioma group than those in control. The percentage of abortion in the endometrioma group was found to higher compared to those with controls.
AFC is more sensitive than the AMH in detecting ovarian response in women with ovarian endometrioma. The individualization of GnRH antagonist protocols in subjects having endometrioma might be improved by using an AFC-tailored approach instead of AMH.
评估窦卵泡计数（AFC）和抗苗勒管激素（AMH）在预测接受 GnRH 拮抗剂治疗的卵巢子宫内膜异位症患者接受 IVF 控制性卵巢刺激时的卵巢反应中的临床价值。
本研究纳入了 50 例接受 GnRH 拮抗剂治疗的卵巢子宫内膜异位症患者，这些患者均进行了首次 IVF/ICSI 周期。平均 AMH 值记录为 1.5-2ng/mL。从男性因素不孕的患者中选择了 50 例不患子宫内膜异位症的不孕妇女作为对照组。根据血清 AMH 水平和年龄进行匹配。两组患者均在接受 IVF 治疗前采集血清样本以测定 AMH 水平。同样，两组患者均在第 3 天进行超声扫描以测量 AFC。记录两组患者的 OPU 期间获得的卵母细胞总数、移植胚胎数、着床率和临床妊娠率、活产率和流产率、rhFSH 的总剂量。
对照组的基础 AFC 明显高于子宫内膜异位症组。取卵时获得的卵母细胞数、MII 卵母细胞数和 2PN 胚胎数均明显低于子宫内膜异位症组。同样，子宫内膜异位症组的受精率、着床率、临床妊娠率和活产率均明显低于对照组。子宫内膜异位症组的 rhFSH 总剂量高于对照组。子宫内膜异位症组的流产率高于对照组。
与 AMH 相比，AFC 更能敏感地检测卵巢子宫内膜异位症患者的卵巢反应。通过采用 AFC 定制方法而不是 AMH 来个体化 GnRH 拮抗剂方案，可能会改善患有子宫内膜异位症的患者的方案。
