Stracquadanio M, Ciotta L, Palumbo M A
a Institute of Obstetric and Gynecological Pathology , Santo Bambino Hospital, University of Catania , Catania , Italy.
Gynecol Endocrinol. 2018 Mar;34(3):223-228. doi: 10.1080/09513590.2017.1381838. Epub 2017 Sep 23.
Polycystic ovary syndrome is a complex disease characterized by various endocrine disorders that are the potential cause of anovulation and hyperandrogenism. Anti-Müllerian hormone expression is suspected to be overexpressed in PCOS granulosa cells. AMH acts as a regulator of folliculogenesis: it is produced by the granulosa cells of follicles from the stage of the primary follicle to the initial formation of the antrum. Serum and intrafollicular AMH levels are elevated in patients with PCOS due to increased number of small follicles and an increased secretion within each of these small follicles. This excess of AMH is strongly suspected to play a role in the characteristic follicular arrest of PCOS, through a negative action on aromatase expression and on FSH action. Value above 5 ng/ml or 35 pmol/l might be considered as a diagnostic criterion for PCOS. The aim of our study is to demonstrate the presence of higher AMH serum levels and higher AMH intrafollicular fluid level of PCOS patients, undergone to IVF cycles, compared to normovulatory patients. The results clearly indicate that blood and intrafollicular AMH levels are significantly higher in PCOS women comparing to the normovulatory population. Serum AMH level appears to be a good predictive marker for the risk ovarian hyperstimulation syndrome: thus, its evaluation should be recommended before starting a controlled ovarian stimulation for IVF.
多囊卵巢综合征是一种复杂的疾病，其特征是存在各种内分泌紊乱，这些紊乱是无排卵和高雄激素血症的潜在原因。抗苗勒管激素的表达在多囊卵巢综合征的颗粒细胞中被怀疑过度表达。抗苗勒管激素作为卵泡发生的调节因子：它由初级卵泡阶段到窦腔初步形成阶段的卵泡颗粒细胞产生。由于小卵泡数量增加以及每个小卵泡内的分泌增加，多囊卵巢综合征患者的血清和卵泡内抗苗勒管激素水平升高。强烈怀疑这种过量的抗苗勒管激素通过对芳香化酶表达和促卵泡生成素作用的负面作用，在多囊卵巢综合征典型的卵泡停滞中发挥作用。高于5 ng/ml或35 pmol/l的值可能被视为多囊卵巢综合征的诊断标准。我们研究的目的是证明与正常排卵患者相比，接受体外受精周期的多囊卵巢综合征患者血清抗苗勒管激素水平更高，卵泡内抗苗勒管激素水平更高。结果清楚地表明，与正常排卵人群相比，多囊卵巢综合征女性的血液和卵泡内抗苗勒管激素水平显著更高。血清抗苗勒管激素水平似乎是卵巢过度刺激综合征风险的良好预测指标：因此，在开始体外受精的控制性卵巢刺激之前，建议对其进行评估。
