血清抗苗勒管激素水平作为体外受精患者卵巢反应不良的预测指标。
Serum anti-Müllerian hormone level as a predictor of poor ovarian response in in vitro fertilization patients.
作者信息
Sahmay Sezai, Cetin Meral, Ocal Pelin, Kaleli Semih, Senol Hulya, Birol Fatih, Irez Tulay
机构信息
Reproductive Endocrinology and IVF Unit İstanbul University Cerrahpasa School of Medicine Istanbul Turkey.
Department of Obstetrics and Gynecology Cumhuriyet University School of Medicine Sivas Turkey.
出版信息
Reprod Med Biol. 2010 Sep 2;10(1):9-14. doi: 10.1007/s12522-010-0066-1. eCollection 2011 Mar.
PURPOSE
To evaluate the clinical value of day 3 serum anti-Müllerian hormone (AMH) compared with day 3 serum follicle-stimulating hormone (FSH) and human chorionic gonadotropin (hCG) day estradiol (E2) levels and antral follicle count (AFC) in the prediction of poor ovarian response in controlled ovarian hyperstimulation (COH).
METHODS
AMH, FSH and AFC on day 3 as well as hCG day E2 levels were determined in 164 subjects. Receiver operating curve analyses and area under curves (AUC) of the study parameters were performed. Predictive values of the levels of day 3 AMH, FSH, AFC, and hCG day E2 as clinical parameters of ovarian response to COH were studied.
RESULTS
Thirty-eight women were defined as poor responders. The day 3 AMH and hCG day E2 levels and AFC of normal responders were significantly higher than those of the poor responders. In predicting poor response, the AUC of day 3 AMH level was significantly higher than that of day 3 FSH level but was similar to the hCG day E2 level. Day 3 AMH, FSH and hCG day E2 levels and AFC were found to predict a poor response. Day 3 AMH and hCG day E2 levels were more predictive compared with day 3 FSH level and AFC. The cut-off level of AMH was ≤2 with a sensitivity of 78.9% and a specificity of 73.8%.
CONCLUSION
Day 3 AMH has the ability to predict a poor response to COH and it is more predictive than day 3 FSH and AFC.
目的
评估在控制性卵巢刺激（COH）中，第3天血清抗苗勒管激素（AMH）与第3天血清促卵泡生成素（FSH）、人绒毛膜促性腺激素（hCG）日雌二醇（E2）水平及窦卵泡计数（AFC）相比，对预测卵巢反应不良的临床价值。
方法
测定164名受试者第3天的AMH、FSH及AFC以及hCG日的E2水平。对研究参数进行受试者操作特征曲线分析及曲线下面积（AUC）计算。研究第3天AMH、FSH、AFC及hCG日E2水平作为COH卵巢反应临床参数的预测价值。
结果
38名女性被定义为反应不良者。正常反应者第3天的AMH、hCG日E2水平及AFC显著高于反应不良者。在预测反应不良方面，第3天AMH水平的AUC显著高于第3天FSH水平，但与hCG日E2水平相似。发现第3天的AMH、FSH、hCG日E2水平及AFC可预测反应不良。与第3天FSH水平和AFC相比，第3天的AMH和hCG日E2水平更具预测性。AMH的临界值为≤2，敏感性为78.9%，特异性为73.8%。
结论
第3天的AMH有能力预测对COH反应不良，且比第3天的FSH和AFC更具预测性。
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