Zhou Yong, Chen Chaolu, Hu Changchang, Wang Yuan, Zhang Xian, Wu Ruijin
Women's Hospital Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People's Republic of China.
J Int Med Res. 2019 Nov;47(11):5643-5649. doi: 10.1177/0300060519861171. Epub 2019 Sep 26.
This study was performed to assess the predictive value of the anti-Müllerian hormone (AMH) serum level for spontaneous pregnancy in women after endometriosis surgery.
In total, 124 patients with suspected ovarian endometrioma planning to undergo laparoscopic ovarian cystectomy were divided into a high AMH group (AMH > 2 ng/mL) and low AMH group (AMH ≤ 2 ng/mL) according to their preoperative AMH levels. The postoperative AMH levels were also measured, and pregnancy outcomes were followed up.
Twenty-one patients were excluded, and 52 pregnancies were registered in the remaining 103 patients diagnosed with endometriosis. The pregnancy rate was significantly greater in the high than low AMH group. Receiver operator characteristics analysis of preoperative AMH, postoperative AMH, and the AMH decline rate showed that preoperative AMH was associated with the greatest area under the curve. Kaplan–Meier curves showed that women in the high AMH group had a significantly higher cumulative pregnancy rate than those in the low AMH group.
The preoperative AMH level might be a useful marker to predict the occurrence of natural pregnancy and could be offered as part of the fertility strategy to women who desire pregnancy after endometriosis surgery.
本研究旨在评估抗苗勒管激素(AMH)血清水平对子宫内膜异位症手术后女性自然妊娠的预测价值。
总共124例疑似卵巢子宫内膜异位囊肿且计划接受腹腔镜卵巢囊肿切除术的患者,根据术前AMH水平分为高AMH组(AMH>2 ng/mL)和低AMH组(AMH≤2 ng/mL)。术后也测量AMH水平,并随访妊娠结局。
21例患者被排除,其余103例诊断为子宫内膜异位症的患者中有52例妊娠。高AMH组的妊娠率显著高于低AMH组。术前AMH、术后AMH及AMH下降率的受试者工作特征分析显示,术前AMH的曲线下面积最大。Kaplan-Meier曲线显示,高AMH组女性的累积妊娠率显著高于低AMH组。
术前AMH水平可能是预测自然妊娠发生的有用标志物,可作为子宫内膜异位症手术后有妊娠意愿女性生育策略的一部分。