Obstet Gynecol. 2019 Apr;133(4):840-841. doi: 10.1097/AOG.0000000000003163.
Antimüllerian hormone is produced by the granulosa cells surrounding each oocyte in the developing ovarian follicle. The production and serum levels of antimüllerian hormone at any given time are reflective of a woman's ovarian reserve, and multiple studies have demonstrated that antimüllerian hormone levels decline across the reproductive lifespan. Data exist to support the use of antimüllerian hormone levels for the assessment of ovarian reserve in infertile women and to select ovarian stimulation protocols in this population; however, using serum antimüllerian hormone levels for fertility counseling in women without a diagnosis of infertility is not currently supported by data from high-quality sources. The obstetrician-gynecologist should exercise caution when considering the predictability of serum antimüllerian hormone levels in any population of women with a low prevalence of infertility, including reproductive-aged women who either have never tried to become pregnant or have become pregnant previously without assistance. Based on the current information, a single serum antimüllerian hormone level assessment obtained at any point in time in a population of women with presumed fertility does not appear to be useful in predicting time to pregnancy and should not be used for counseling patients in this regard. At this time, routine antimüllerian hormone testing for prediction of pregnancy loss is not recommended. More data are needed to determine the utility of antimüllerian hormone as a predictor of time to menopause, a biomarker for polycystic ovary syndrome, or a predictor of future menses in women who have received gonadotoxic therapy.
抗缪勒管激素由发育中的卵巢滤泡中每个卵子周围的颗粒细胞产生。在任何特定时间,抗缪勒管激素的产生和血清水平反映了女性的卵巢储备情况,多项研究表明,抗缪勒管激素水平在生殖寿命期间下降。有数据支持使用抗缪勒管激素水平评估不孕女性的卵巢储备,并为该人群选择卵巢刺激方案;然而,目前尚无高质量来源的数据支持在没有不孕诊断的女性中使用血清抗缪勒管激素水平进行生育咨询。对于低不孕患病率的任何女性人群,包括从未尝试怀孕或以前未经辅助怀孕的育龄妇女,妇产科医生在考虑血清抗缪勒管激素水平的可预测性时应谨慎。根据目前的信息,在具有生育能力的人群中,在任何时间点获得的单个血清抗缪勒管激素水平评估似乎都不能预测妊娠时间,不应用于在这方面为患者提供咨询。目前,不建议常规进行抗缪勒管激素检测以预测妊娠丢失。需要更多的数据来确定抗缪勒管激素作为预测绝经时间、多囊卵巢综合征生物标志物或接受性腺毒性治疗的女性未来月经的预测因子的效用。