血清抗缪勒管激素水平与免疫性不孕症及体外受精——胚胎移植妊娠结局的相关性  

The correlation between serum anti-Mullerian hormone level and immune infertility and pregnancy outcome of in vitro fertilization-embryo transfer

作　　者：管荷琴[1] 周洁[1] 徐丹萍[1] GUAN He-Qin;ZHOU Jie;XU Dan-Ping(Taizhou Hospital Infertility and Eugenics,Taizhou,Zhejiang 317000,China)

机构地区：[1]浙江省台州医院不孕与优生科

出　　处：《中国妇幼保健》2019年第22期5255-5258,共4页Maternal and Child Health Care of China

基　　金：浙江省公益技术应用研究项目(2017C33217)

摘　　要：目的 探讨血清抗缪勒管激素(AMH)水平与免疫性不孕症及体外受精-胚胎移植(IVF-ET)妊娠结局的关系。方法 根据不孕因素将200例不孕症患者分为A组(输卵管因素)、B组(内分泌因素)、C组(子宫因素)、D组(免疫因素)。搜集4组的临床资料,对比血清AMH检测结果。另选取106例行IVF-ET治疗的不孕症患者,根据血清AMH水平分为高AMH组、中AMH组、低AMH组,对比3组患者的年龄、促排卵情况及妊娠结局。结果 A、B、C、D 4组的血清AMH水平比较,差异有统计学意义(P<0. 05),B组的血清AMH水平显著高于另外3组(P<0. 05),A、C、D组的血清AMH水平比较,差异无统计学意义(P>0. 05)。高AMH组、中AMH组和低AMH组患者的Gn总量、MⅡ卵数、优质胚胎数、可移植胚胎数、取卵周期数比较,差异均有统计学意义(均P<0. 05)。高AMH组中,妊娠亚组与非妊娠亚组的年龄比较,差异无统计学意义(P>0. 05);中AMH组和低AMH组中,妊娠亚组平均年龄均显著低于非妊娠亚组(P<0. 05)。不论是高AMH组,还是中AMH组或低AMH组,妊娠亚组和非妊娠亚组AMH水平比较,差异均无统计学意义(均P>0. 05)。IVF-ET患者的血清AMH水平与Gn总量、MⅡ卵数、优质胚胎数、可抑制胚胎数、累计妊娠率均呈正相关,与取卵周期数呈负相关(P <0. 05)。结论 血清AMH水平与免疫性不孕症无明显相关性,但与内分泌性不孕有关。AMH水平可较好地预测IVF-ET的临床妊娠率,同时年龄也是影响IVF-ET助孕结局的重要因素。Objective To investigate the relationship between serum anti-Mullerian hormone(AMH)levels and pregnancy outcomes in immunological infertility and in vitro fertilization-embryo transfer(IVF-ET).Methods 200 infertile patients were divided into group A(fallopian tube factor),group B(endocrine factor),group C(uterine factor)and group D(immune factor)according to the factors of in-fertility.The clinical data of 4 groups were collected and the results of serum AMH were compared.Another 106 infertility patients treated with IVF-ET were divided into high AMH group,middle AMH group and low AMH group according to serum AMH level.Age,ovulation induc-tion and pregnancy outcome of the three groups were compared.Results There was significant difference in serum AMH levels between groups A,B,C and D(P<0.05).Serum AMH levels in group B were significantly higher than those in other three groups(P<0.05).There was no significant difference in serum AMH levels between groups A,C and D(P>0.05).There were significant differences in total Gn,MII eggs,high quality embryos,transplantable embryos and egg collection cycles between high AMH group,medium AMH group and low AMH group(P<0.05).There was no significant difference in age between pregnant and non-pregnant subgroups in high AMH group(P>0.05);the average age of pregnant subgroup was significantly lower in middle AMH group and low AMH group than in non-pregnant subgroup(P<0.05).There was no significant difference in AMH levels between pregnant and non-pregnant subgroups(P>0.05),no matter in high AMH group,medium AMH group or low AMH group.Serum AMH levels in IVF-ET patients were positively correlated with total Gn,number of MII eggs,number of high-quality embryos,number of inhibited embryos and cumulative pregnancy rate,and nega-tively correlated with the number of oocyte retrieval cycles(P<0.05).Conclusion Serum AMH level is not correlated with immune infer-tility,but with endocrine infertility.AMH level can better predict the clinical pregnancy rate of IVF-ET,and age is also an impo

关 键 词：血清抗缪勒管激素 免疫性不孕症 体外受精-胚胎移植 妊娠结局 

分 类 号：R711.6[医药卫生—妇产科学]