卵泡液抗苗勒氏管、激活素A及骨形成蛋白对不孕女性卵巢反应性及妊娠结局的预测价值  

The value of follicular fluid AMH,Activin A and BMP-15 in ovarian response and pregnancy outcome in infertile women

作　　者：衷雪梅 金萱[2] ZHONG Xuemei;JIN Xuan(Medical College of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学医学院,南昌330006 [2]南昌大学第一附属医院辅助生殖中心,南昌330006

出　　处：《实用医学杂志》2019年第6期878-882,共5页The Journal of Practical Medicine

基　　金：国家自然科学基金资助项目(编号:81760285);国家自然科学基金资助项目(编号:31160246)

摘　　要：目的探讨在黄体中期长方案中,卵泡液抗苗勒氏管激素(AMH),骨形成蛋白(BMP-15)以及激活素A(Activin A)对卵巢反应性以及年龄<35岁患者临床妊娠的预测价值。方法将155例在本中心行长方案超促排卵周期治疗的不孕患者根据卵巢反应性分为低反应、正常反应和高反应组;根据年龄及妊娠结局分为<35岁妊娠组和未妊娠组;采用ELISA双抗体夹心法检测患者卵泡液AMH、BMP-15和Activin A浓度;采用Logistic回归及受试者工作特征曲线(ROC)分析3种卵泡液成分对卵巢反应性及妊娠结局的预测价值。结果卵泡液BMP-15与卵巢反应有相关性(P <0.05);患者年龄<35岁时,卵泡液Activin A与妊娠结局有相关性(P <0.05);AMH和BMP-15预测妊娠结局的ROC曲线下面积分别是0.748和0.76,临界值分别为736.8 pg/mL和27.26 pg/mL。结论对于年轻患者(年龄<35岁),卵泡液AMH、BMP-15是临床妊娠结局的有效独立预测因子。Objective Exploration of the potential of follicular fluid anti-Müllerian hormone(AMH), bone protein(BMP-15)and activin A(Activin A)value in predicting ovarian response and clinical pregnancy in patients whose age less than 35 in the mid-limb luteal regimen. Methods 155 Infertile patients undergone controlled ovarian stimulation therapy in our reproductive center were divided into three groups(low,normal and high reactivity)according to ovarian reactivity and these patients were also divided into two groups(< 35-year-old pregnant and non-pregnant)according to age and pregnancy outcomes. Follicular fluid(FF)were collected during oocytes retrieval. The concentration of AMH,BMP-15 and Activin A in FF samples were detected by double-antibody sandwich ELISA. The logistic regression analysis and receiver operating characteristic curve(ROC)were used to analyze the predictive value of three follicular fluid components for ovarian reactivity and pregnancy outcomes. Result BMP-15 in follicular fluid corresponded to ovarian reactivity(P < 0.05). Activin A in follicular fluid corresponded to pregnancy outcomes in patients younger than 35 years old(P < 0.05). And the area under the receiver operating characteristic curve(AUC)analysis of AMH and BMP-15 for pregnancy outcome were 0.748 and 0.76 respectively,and the cut-off points of them were 736.8 pg/mL and 27.26 pg/mL respectively. Conclusion FF AMH and FFBMP-15 can serve as an effective reference data for prediction of clinical pregnancy outcomes in younger patients(age <35 years).

关 键 词：BMP-15 AMH ACTIVIN A 黄体中期长方案 卵巢反应 妊娠结局 

分 类 号：R714.8[医药卫生—妇产科学]