精浆抗苗勒管激素水平与体外受精周期中受精率的相关性研究  

The correlation between seminal plasma anti-Müllerian hormone level and fertilization rate in IVF cycles

作　　者：冼英杰 陈润强[1] 李付广[1] 乔静 周秀琴[1] 冯玲 邱佩嫦[1] 陈彩蓉[1] XIAN Yingjie;CHEN Runqiang;LI Fuguang;QIAO Jing;ZHOU Xiuqin;FENG Ling;QIU Peichang;CHEN Cairong(Center for Reproductive Medicine,the Sixth Affiliated Hospital of Guangzhou Medical University/Qingyuan People's Hospital,Qingyuan,Guangdong 511500,China)

机构地区：[1]广州医科大学附属第六医院/广东省清远市人民医院生殖医学中心,广东清远511500

出　　处：《检验医学与临床》2021年第11期1512-1515,1520,共5页Laboratory Medicine and Clinic

基　　金：广东省医学科研基金项目(B2018111)。

摘　　要：目的分析常规体外受精(IVF)周期中精浆抗苗勒管激素(AMH)水平与受精率之间的相关性,探讨其对IVF受精率的预测价值。方法选取2018-2020年在该院生殖医学中心行IVF治疗的不孕不育夫妇170对进行前瞻性研究,按男方精液参数将纳入研究的夫妇分为3组:正常精子组、高精子总数组和弱精子组。在取卵日取精液检测精浆AMH水平并进行IVF受精,计算精浆AMH、精液参数与受精率之间的相关系数,并采用受试者工作特征(ROC)曲线评估其对受精率的预测能力。结果在整体研究人群中,男方总精子数、精子浓度、前向运动精子比例(PR)、总活力、精浆AMH均与受精率呈正相关(r=0.460、0.566、0.308、0.346、0.478,P<0.05),用于受精率预测的ROC曲线下面积(AUC)分别为0.539、0.595、0.599、0.606和0.647;在弱精子组中,精浆AMH和PR与受精率呈正相关(r=0.299、0.266,P<0.05),用于受精率预测的AUC分别为0.665和0.511;正常精子组、高精子总数组精浆AMH及精液参数与受精率则没有显著相关性(P>0.05)。结论在整体研究人群和弱精子症患者中,精浆AMH与IVF受精率有显著相关性,可作为预测不孕不育患者IVF受精率的实验室指标。Objective To analyze the correlation between seminal plasma anti-Müllerian(AMH)and fertilization rate of in vitro fertilization(IVF)and explore its predictive value for IVF fertilization rate.Methods This is a prospective study and 170 infertile couples who were underwent IVF treatment in the reproductive center from 2018 to 2020 were enrolled in the study.The couples were divided into 3 groups:normal group,high sperm count group and asthenozoospermia group,according to the semen parameters of the males.On the day of picking up oocytes,semen was collected for AMH detection.The correlation coefficient between seminal plasma AMH,semen parameters and fertilization rate was calculated,and ROC was used to evaluate their predictive value for IVF fertilization rate.Results In the overall study population,the men's total sperm count,sperm concentration,forward motility sperm ratio(PR),total motility,seminal plasma AMH were all positively correlated with fertilization rate(r=0.460,0.566,0.308,0.346,0.478,P<0.05),the areas under the ROC curve(AUCs)used for fertilization rate prediction were 0.539,0.595,0.599,0.606 and 0.647,respectively;in the weak sperm group,seminal plasma AMH and PR were positively correlated with fertilization rate(r=0.299,0.266,P<0.05),the AUCs used for fertilization rate prediction were 0.665 and 0.511,respectively;the seminal plasma AMH and semen parameters in the normal sperm group and the high sperm count group were not significantly correlated with the fertilization rate(P>0.05).Conclusion In the overall study population and patients with asthenospermia,seminal plasma AMH has a significant correlation with IVF fertilization rate,which can be used as a laboratory indicator to predict IVF fertilization rate of infertility patients.

关 键 词：抗苗勒管激素 精液参数 受精率 

分 类 号：R446.19[医药卫生—诊断学]