Grbavac Ivan, Zec Ivana, Ljiljak Dejan, Rakoš Justament Romina, Bukovec Megla Željka, Kuna Krunoslav
Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia.
Laboratory of Endocrinology, Oncology and Nuclear Medicine Departments, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia.
Acta Clin Croat. 2018 Mar;57(1):177-180. doi: 10.20471/acc.2018.57.01.24.
We report a unique case of undetectable serum levels of anti-müllerian hormone (AMH) in women with polycystic ovary syndrome (PCOS) who developed ovarian hyperstimulation syndrome (OHSS) during in vitro fertilization (IVF). A case is described of a 28-year-old woman with clinical symptoms of PCOS and AMH serum level below analytical sensitivity (<1.0 pmol/L). After undergoing controlled ovarian stimulation, the patient developed OHSS. After follicle aspiration, seven oocytes were recovered. Three of them were used for intracytoplasmic sperm injection (ICSI) and fertilized, but with unsuccessful pregnancy outcome. A successful pregnancy was achieved in the second IVF/ICSI cycle with six oocytes retrieved and three embryos transferred. At 39 weeks of gestation, the patient delivered a healthy baby weighing 3930 g and 50 cm long. In conclusion, although AMH is considered a useful tool in ovarian reserve assessment and in predicting response to controlled ovarian hyperstimulation, the case presented shows that AMH should not be used as an independent ovarian marker.
我们报告了一例多囊卵巢综合征(PCOS)女性患者在体外受精(IVF)期间发生卵巢过度刺激综合征(OHSS),但其血清抗苗勒管激素(AMH)水平检测不到的独特病例。描述了一名28岁有PCOS临床症状且AMH血清水平低于分析灵敏度(<1.0 pmol/L)的女性病例。在接受控制性卵巢刺激后,该患者发生了OHSS。卵泡抽吸术后,回收了7个卵母细胞。其中3个用于卵胞浆内单精子注射(ICSI)并受精,但妊娠结局未成功。在第二个IVF/ICSI周期中,获取了6个卵母细胞并移植了3个胚胎,成功实现了妊娠。妊娠39周时,患者分娩了一名健康婴儿,体重3930 g,身长50 cm。总之,尽管AMH被认为是评估卵巢储备和预测控制性卵巢过度刺激反应的有用工具,但本病例表明AMH不应作为独立的卵巢标志物使用。