抗苗勒管激素对控制性促排卵卵巢低反应的预测价值  

Value of anti-Müllerian hormone in prediction of poor ovarian response to controlled ovarian stimulation

作　　者：宋玮[1] 牛志宏[1] 陈骞[1] 冯云 

机构地区：[1]上海交通大学医学院瑞金医院生殖医学中心,上海200025

出　　处：《上海交通大学学报（医学版）》2010年第5期566-569,共4页Journal of Shanghai Jiao tong University:Medical Science

摘　　要：目的评估抗苗勒管激素(AMH)对控制性促排卵卵巢低反应的预测价值。方法测定54例首次行体外授精(IVF)或卵胞质内单精子显微注射(ICSI)患者的基础卵泡刺激素(bFSH)、基础黄体生成素(bLH)、基础雌二醇(bE2)、双侧卵巢窦卵泡计数(AFC)和血清AMH。通过受试者工作特征(ROC)曲线分析各指标对卵巢低反应的预测价值。结果 11例(20.4%)卵巢反应低下者(获卵数≤5)血清AMH水平低于卵巢正常反应者[(1.46±0.46)ng/mLvs(2.36±1.12)ng/mL],差异有统计学意义(P<0.05)。ROC曲线分析显示,AMH和AFC曲线下面积(AUC)分别为0.774和0.728(P<0.01,P<0.05);各项基础性激素AUC均<0.5(P>0.05)。当AMH截断值≤1.64ng/mL时,灵敏度为81.8%,特异度为72.1%;当AFC截断值<6时,灵敏度为63.6%,特异度为76.7%。结论在控制性促排卵中,血清AMH可作为卵巢对外源性促性腺激素反应不良的预测指标。Objective To evaluate anti-Müllerian hormone（AMH）in prediction of poor ovarian response to controlled ovarian hyperstimulation.Methods The serum levels of basal follicle-stimulating hormone（bFSH）,basal luteinizing hormone（bLH）,basal estradiol（bE2）,bilateral antral follicle count（AFC）and AMH in 54 patients with first cycle of in vitro fertilization（IVF）/intracytoplasmic sperm injection（ICSI）were determined.The values of each parameter in prediction of poor ovarian response were assessed using receiver-operating characteristic（ROC）curves.Results The serum AMH level of 11 patients（20.4%）with poor ovarian response（no more than five oocytes）was significantly lower than that of patients with normal ovarian response [（1.46±0.46）ng/mL vs（2.36±1.12）ng/mL,P0.05].ROC curve analysis revealed that area under curve（AUC）was 0.774 for AMH（P0.01）and 0.728 for AFC（P0.05）,and AUC was less than 0.5 for each basal hormone（P0.05）.The sensitivity and specificity were 81.8% and 72.1%,respectively when the cutoff value of AMH was no higher than 1.64 ng/mL,and the sensitivity and specificity were 63.6% and 76.7%,respectively when the cutoff value of AFC was less than 6.Conclusion Serum AMH may serve as a predictor for poor ovarian response to exogenous gonadotrophin in patients undergoing controlled ovarian hyperstimulation.

关 键 词：抗苗勒管激素 促排卵 卵巢反应 

分 类 号：R714.8[医药卫生—妇产科学]