反米勒尔激素的周期间变异性:对预测受控卵巢刺激周期结果的影响
Yavuz Emre Şükür1,2, Batuhan Aslan3, Necati Berk Kaplan3
1Department of Obstetrics and Gynecology, Ankara University Faculty of Medicine, Ankara, Turkiye, Türkiye. yesukur@gmail.com.
Journal of ovarian research
|October 26, 2024
概括
抗穆勒尔激素 (AMH) 水平在周期之间大幅波动,影响卵巢储备评估. 在受控卵巢刺激 (COS) 周期期间测量AMH可以更准确地预测用于生育治疗的卵细胞产量.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 不孕症研究 不孕症研究
- 临床生物化学 临床生物化学
背景情况:
- 抗穆勒尔激素 (AMH) 是卵巢储备的关键标志物,可以预测卵巢刺激反应.
- 一般来说,AMH被认为是稳定的,但由于年龄和月经周期阶段等因素,显示出显著的周期间变化.
- 这种变化使得对个体反应的准确预测变得复杂,特别是当AMH在受控卵巢刺激 (COS) 周期中没有测量时.
研究的目的:
- 为了评估血清AMH水平在两个连续月经周期的周期间的变化.
- 评估AMH水平与受控卵巢刺激 (COS) 结果之间的相关性.
- 确定AMH测量的最佳时间,以预测卵巢反应.
主要方法:
- 79名正常和不良反应患者接受细胞内质精子注射 (ICSI) 的回顾性队列研究.
- 使用Elecsys-AMH Roche系统测量的血清AMH水平,在两个连续周期的早期卵泡阶段.
- 分析了AMH水平与COS后的总卵细胞/成熟卵细胞 (MII) 计数之间的相关性.
主要成果:
- 观察到 AMH 周期间的显著变化 (中位数为 44.3%).
- 根据第二次测量,大约20%的患者被重新分类为正常和不良反应类别.
- 在COS周期中测量的AMH与总卵细胞 (r=0.871) 和MII卵细胞 (r=0.820) 数量有很强的相关性.
结论:
- 血清AMH水平显示出大量的周期间变化,可能导致患者错误分类.
- 在COS周期的卵泡早期阶段测量AMH可以更可靠地预测卵细胞产量.
- 在COS周期内重复的AMH测量和计时对于在生育治疗中做出明智的临床决策至关重要.
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