使用抗苗勒管激素自动化检测法确定印度裔育龄女性多囊卵巢综合征诊断的抗苗勒管激素临界值
Establishing an Anti-Müllerian Hormone Cutoff for Diagnosis of Polycystic Ovarian Syndrome in Women of Reproductive Age-Bearing Indian Ethnicity Using the Automated Anti-Müllerian Hormone Assay.
作者信息
Mahajan Nalini, Kaur Jasneet
机构信息
Department of Reproductive Medicine, Mother and Child Hospital, Delhi, India.
出版信息
J Hum Reprod Sci. 2019 Apr-Jun;12(2):104-113. doi: 10.4103/jhrs.JHRS_149_18.
CONTEXT
Polycystic ovary syndrome diagnosed by Rotterdam criteria, is the most common cause of anovulatory infertility. The criteria of polycystic ovarian morphology (PCOM) are subject to operator variability and technological advances. Serum anti-Müllerian hormone (AMH) level has been proposed as a more reliable alternative to antral follicle count. There is a paucity of data on use of AMH for diagnosis of PCOS in Indian women.
AIM AND OBJECTIVES
The aim of this study is to determine a cutoff level for AMH that could facilitate diagnosis of PCOS and its phenotypes in women of Indian origin using the automated (Roche) assay and to compare the competence of oocytes in PCOS and non-PCOS women undergoing fertilization-intracytoplasmic sperm injection (IVF-ICSI).
MATERIALS AND METHODOLOGY
A total of 367 women undergoing treatment at our fertility center between February 2017 and August 2017 were prospectively enrolled in this study. Of these, 133 were diagnosed with PCOS, 69 had isolated PCOM, and 165 (controls) had normal ovaries on ultrasound examination. Serum AMH levels were assessed using the fully automated Roche Elecsys immunoassay. Gonadotropin-releasing hormone antagonist protocol was used for IVF-ICSI in all patients.
STATISTICAL ANALYSIS USED
Quantitative variables were compared using the Mann-Whitney test. Qualitative variables were correlated using the Chi-square test. < 0.05 was considered to be statistically significant.
RESULTS
Mean AMH concentrations in women with PCOS was higher (7.56 ± 4.36 ng/mL) in comparison to PCOM and controls. Serum AMH concentration >5.03 ng/mL could facilitate diagnosis of PCOS (area under the curve = 0.826); sensitivity -70.68%, specificity of 79.91%. There was no difference in the ratio of mature to total oocytes retrieved in the three groups ( > 0.05). Mean number of mature oocytes was lower in controls than PCOS and PCOM ( < 0.001).
CONCLUSIONS
Serum AMH concentration >5.03 ng/mL could be used as cutoff value for the diagnosis of PCOS in women of Indian origin.
背景
根据鹿特丹标准诊断的多囊卵巢综合征是无排卵性不孕最常见的原因。多囊卵巢形态（PCOM）的标准受操作者差异和技术进步的影响。血清抗苗勒管激素（AMH）水平已被提议作为窦卵泡计数更可靠的替代指标。关于在印度女性中使用AMH诊断多囊卵巢综合征（PCOS）的数据较少。
目的
本研究的目的是确定使用自动化（罗氏）检测法时，AMH的一个临界值，该临界值有助于诊断印度裔女性的PCOS及其表型，并比较接受体外受精-卵胞浆内单精子注射（IVF-ICSI）的PCOS和非PCOS女性的卵母细胞能力。
材料与方法
2017年2月至2017年8月期间在我们生育中心接受治疗的367名女性被前瞻性纳入本研究。其中，133例被诊断为PCOS，69例有孤立性PCOM，165例（对照组）超声检查卵巢正常。使用全自动罗氏电化学发光免疫分析法评估血清AMH水平。所有患者均采用促性腺激素释放激素拮抗剂方案进行IVF-ICSI。
所用统计分析方法
定量变量采用曼-惠特尼检验进行比较。定性变量采用卡方检验进行相关性分析。P<0.05被认为具有统计学意义。
结果
与PCOM和对照组相比，PCOS女性的平均AMH浓度更高（7.56±4.36 ng/mL）。血清AMH浓度>5.03 ng/mL有助于诊断PCOS（曲线下面积=0.826）；敏感性为70.68%，特异性为79.91%。三组中回收的成熟卵母细胞与总卵母细胞的比例无差异（P>0.05）。对照组成熟卵母细胞的平均数量低于PCOS组和PCOM组（P<0.001）。
结论
血清AMH浓度>5.03 ng/mL可作为印度裔女性PCOS诊断的临界值。
Zotero 插件