低抗苗勒管激素水平与年轻不孕女性自然妊娠结局的关系研究  

Study on the relationship between low anti-Müllerian hormone levels and natural pregnancy outcome in young infertile women

作　　者：黄芳[1] 钟嘉莉[1] 李琼珍[1] 彭顺英[1] 赵花[1] HUANG Fang;ZHONG Jiali;LI Qiongzhen;PENG Shunying;ZHAO Hua(Department of Obstetrics and Gynecology,The First People's Hospital of Zhaoqing City,Zhaoqing Guangdong 526040,P.R.China)

机构地区：[1]肇庆市第一人民医院妇产科,广东肇庆526040

出　　处：《中国计划生育和妇产科》2021年第6期81-84,共4页Chinese Journal of Family Planning & Gynecotokology

基　　金：广东省肇庆市科技创新计划项目(项目编号:201804030918)。

摘　　要：目的探讨低抗苗勒管激素(anti-müllerian hormone,AMH)水平与年轻不孕患者自然妊娠结局的关系,为临床AMH的早期评估价值与应用提供参考。方法选择2017年8月至2018年10月肇庆市第一人民医院生殖不孕中心收治的104例年轻不孕症患者为研究对象,年龄20~34岁,按AMH水平将患者分为3组,A组:极低AMH组26例(AMH<0.5 ng/mL);B组:低AMH组38例(0.5 ng/mL≤AMH<1.1 ng/mL);C组:正常AMH组40例(AMH≥1.1 ng/mL)。对3组患者定期随诊、电话联系监测患者情况,指导同房,并了解是否自然妊娠及其妊娠结局。比较3组患者的自然妊娠率、活产率、流产率和异位妊娠率是否存在差异。结果A组患者自然妊娠率(26.9%)明显低于C组(57.5%),差异有统计学意义(P<0.05),但B组(50%)和C组比较,A组和B组间比较,差异均无统计学意义(χ^(2)=0.441、3.408,P=0.507、0.065)。A组活产率(19.2%)较B组(44.7%)和C组(47.5%)低,差异有统计学意义(P<0.05),A组流产率(7.7%)高于后两组(2.6%、5%),差异无统计学意义(P>0.05)。B组和C组间活产率、流产率比较,差异均无统计学意义(P>0.05)。3组间异位妊娠发生率比较,差异无统计学意义(P>0.05)。结论对于无其他不孕因素的年轻女性,AMH水平为0.5~1.1 ng/mL的妊娠结局与AMH≥1.1 ng/mL的女性相似。极低AMH水平(<0.5 ng/mL)的年轻患者生育力下降,不良妊娠结局增加,建议采取更积极的助孕措施,如人工授精、体外授精胚胎移植等,以免错失生育时机。Objective To explore the relationship between low anti-müllerian hormone(AMH)levels and natural pregnancy outcomes in young infertile patients,and to provide references for the early evaluation and application of clinical AMH.Methods A total of 104 young infertility patients,aged 20~34,who were admitted to the Reproductive and Infertility Center of Zhaoqing First People’s Hospital from August 2017 to October 2018 were selected as the research subjects.The patients were divided into 3 groups according to the AMH level.Group A:26 cases in the very low AMH group(AMH<0.5 ng/mL);Group B:38 cases in the low AMH group(0.5 ng/mL≤AMH<1.1 ng/mL);Group C:40 cases in the normal AMH group(AMH≥1.1 ng/mL).The 3 groups of patients were regularly followed up and contacted by telephone to monitor the condition of the patients,to guide the intercourse,and to understand whether the natural pregnancy and the outcome of the natural pregnancy.Compared the natural pregnancy rate,live birth rate,miscarriage rate and ectopic pregnancy rate among the 3 groups.Results The natural pregnancy rate of patients in group A(26.9%)was significantly lower than that of group C(57.5%),and the difference was statistically significant(P<0.05),but there were no significant differences between group B and group C,and between group A and B(χ^(2)=0.441、3.408,P=0.507、0.065).The live birth rate(19.2%)of group A was lower than that of group B(44.7%)and group C(47.5%),and the difference was statistically significant(P<0.05).The abortion rate of group A(7.7%)was higher than the latter two group(2.6%,5%),but the difference was not statistically significant(P>0.05).There was no statistically significant comparison of live birth rate and abortion rate between group B and group C(P>0.05).There was no significant difference in the incidence of ectopic pregnancy among the three groups(P>0.05).Conclusion For young women without other infertility factors,pregnancy outcomes with AMH levels of 0.5~1.1 ng/mL are similar to women with AMH≥1.1 ng/mL.Young patie

关 键 词：抗苗勒管激素 年轻女性 不孕 自然妊娠 

分 类 号：R711.6[医药卫生—妇产科学]