Laboratory of Hormonology and Tumour Markers, Universitair Ziekenhuis Brussel, Free University of Brussels, Brussels, Belgium.
Roche Diagnostics GmbH, Penzberg, Germany.
Eur J Obstet Gynecol Reprod Biol. 2019 May;236:133-138. doi: 10.1016/j.ejogrb.2019.02.022. Epub 2019 Mar 2.
This non-interventional study aimed to validate a pre-specified anti-Müllerian hormone (AMH) cut-off of 15 pmol/L (2.10 ng/mL) for the prediction of hyper-response to controlled ovarian stimulation (COS) using the fully automated Elecsys AMH immunoassay.
One hundred and forty-nine women aged <44 years with regular menstrual cycles underwent COS with 150 IU/day follicle-stimulating hormone in a gonadotrophin-releasing hormone (GnRH) antagonist protocol. Response to COS (poor vs normal vs hyper-response) was defined by number of oocytes retrieved and occurrence of ovarian hyper-stimulation syndrome (OHSS).
Significant differences were seen between response classes for the number of follicles prior to follicle puncture (p < 0.001), the number of retrieved oocytes (p < 0.001) and the occurrence of OHSS (p < 0.001), which were all highest in hyper-responders. The area under the receiver operating characteristic curve for AMH to predict hyper-response was 82.1% (95% confidence interval [CI]: 72.5-91.7). When applying the AMH cut-off of 15.0 pmol/L, a sensitivity of 81.3% (95%CI: 54.4-96.0) to predict hyper-response and a specificity of 64.7% (95%CI: 55.9-72.8) to identify poor/normal responders was reached.
The Elecsys AMH assay can reliably predict hyper-response to COS in women undergoing a GnRH antagonist treatment protocol.
本非介入性研究旨在验证使用全自动 Elecsys AMH 免疫分析法，将抗苗勒管激素（AMH）的预设截断值 15pmol/L（2.10ng/mL）用于预测控制性卵巢刺激（COS）的高反应。
149 名年龄<44 岁、月经周期规律的女性接受了促性腺激素释放激素（GnRH）拮抗剂方案下的 150IU/天卵泡刺激素的 COS。根据获得的卵母细胞数量和卵巢过度刺激综合征（OHSS）的发生情况，将 COS 反应（差、正常和高反应）定义。
在卵泡穿刺前卵泡数量（p<0.001）、获得的卵母细胞数量（p<0.001）和 OHSS 的发生（p<0.001）方面，反应类别之间存在显著差异，这些差异在高反应者中最高。AMH 预测高反应的受试者工作特征曲线下面积为 82.1%（95%置信区间：72.5-91.7）。当应用 AMH 截断值 15.0pmol/L 时，预测高反应的敏感性为 81.3%（95%CI：54.4-96.0），特异性为 64.7%（95%CI：55.9-72.8），以识别差/正常反应者。
Elecsys AMH 测定法可可靠地预测 GnRH 拮抗剂治疗方案中女性对 COS 的高反应。
