Lee Maw-Sheng, Tzeng Shu-Ling, Yang Shun-Fa, Lin Yi-Ping, Cheng En-Hui, Huang Chun-Chia, Yang Yu-Shih, Lee Tsung-Hsien
Institute of Medicine, School of Medicine, Chung Shan Medical University, 402 Taichung, Taiwan; Department of Obstetrics and Gynecology, School of Medicine, Chung Shan Medical University, 402 Taichung, Taiwan; Division of Infertility Clinic, Lee Women's Hospital, 406 Taichung, Taiwan.
Institute of Medicine, School of Medicine, Chung Shan Medical University, 402 Taichung, Taiwan.
Clin Chim Acta. 2017 Aug;471:327-333. doi: 10.1016/j.cca.2017.06.023. Epub 2017 Jul 3.
Serum anti-Mullerian hormone (AMH) is a predictor of the pregnancy outcome in assisted reproductive technology (ART) cycles, particularly for older women. This study attempts to elucidate the effect of serum AMH on follicular hormone profiles and implantation outcome of the ensuing embryos in ART cycles. A total of 412 patients undergoing ART cycles at a private infertility center were included and 780 follicular fluid samples were collected. Levels of follicular hormones, including FSH, LH, inhibin B, AMH, estradiol, progesterone, and androstenedione were measured. The implantation outcome of the ensuing embryos was traced as a main outcome measure. We demonstrated that the follicular levels of estradiol, progesterone, and androstenedione were considerably similar, but the overall implantation rates increased as the serum AMH increased. Logistic regression analysis revealed that the best predictor for embryo implantation was follicular FSH (>9.64mIU/mL, odds ratio [OR] 0.9). Furthermore, serum AMH (Spearman's rho=-0.352) and female age (rho=0.369) are correlated with follicular FSH levels in those follicles. In conclusion, the serum AMH might affect follicular hormone profiles by interaction with gonadotrophin rather than with steroidogenesis. The follicular FSH levels are correlated with the implantation potential of the ensuing embryos.
血清抗苗勒管激素(AMH)是辅助生殖技术(ART)周期中妊娠结局的一个预测指标,对年龄较大的女性尤为如此。本研究旨在阐明血清AMH对ART周期中卵泡激素谱及随后胚胎着床结局的影响。纳入了一家私立不孕不育中心412例行ART周期的患者,并收集了780份卵泡液样本。检测了卵泡激素水平,包括促卵泡生成素(FSH)、促黄体生成素(LH)、抑制素B、AMH、雌二醇、孕酮和雄烯二酮。追踪随后胚胎的着床结局作为主要结局指标。我们发现,卵泡中的雌二醇、孕酮和雄烯二酮水平相当相似,但随着血清AMH升高,总体着床率增加。逻辑回归分析显示,胚胎着床的最佳预测指标是卵泡FSH(>9.64mIU/mL,比值比[OR]为0.9)。此外,血清AMH(斯皮尔曼等级相关系数rho=-0.352)和女性年龄(rho=0.369)与这些卵泡中的卵泡FSH水平相关。总之,血清AMH可能通过与促性腺激素相互作用而非与类固醇生成相互作用来影响卵泡激素谱。卵泡FSH水平与随后胚胎的着床潜力相关。