不孕症患者血清AMH和E2水平对卵巢储备功能、治疗后卵巢反应及妊娠结局的预测价值  

The predictive value of serum anti-Müllerian hormone and estradiol on ovarian reserve function,post-treatment ovarian response and pregnancy outcome in infertile patients

作　　者：钱靖 钱东林 朱国祥 QIAN Jing;QIAN Donglin;ZHU Guoxiang(Department of Laboratory Medicine,Suzhou Ninth People′s Hospital,Suzhou 215200,Jiangsu,China;Department of Pathology,Nantong Maternal and Child Health Hospital,Nantong 226001,Jiangsu,China)

机构地区：[1]苏州市第九人民医院检验科,江苏苏州215200 [2]南通市妇幼保健院病理科,江苏南通226001

出　　处：《中国性科学》2024年第10期56-60,共5页Chinese Journal of Human Sexuality

基　　金：江苏省南通市科技计划项目(MSZ20007)。

摘　　要：目的探讨不孕症患者血清抗米勒管激素(AMH)和雌二醇(E_(2))水平对卵巢储备功能、脱氢表雄酮(DHEA)治疗后卵巢反应及妊娠结局的预测价值。方法选取2020年7月至2022年6月苏州市第九人民医院收治的108例不孕症患者作为研究对象,所有患者均给予DHEA治疗。比较卵巢储备功能降低、卵巢低反应患者与正常患者血清AMH和E_(2)水平,采用受试者工作特征(ROC)曲线分析血清AMH和E_(2)水平对卵巢储备功能降低、血清AMH对卵巢低反应的预测价值,比较不同妊娠结局患者的临床资料。结果卵巢储备功能降低患者血清AMH低于正常患者,血清E_(2)高于正常患者(P<0.05)。血清AMH和E_(2)预测卵巢储备功能降低的ROC曲线的曲线下面积(AUC)分别为0.805、0.775(P<0.05)。卵巢低反应患者血清AMH低于正常患者(P<0.05)。血清AMH预测卵巢低反应的ROC曲线的AUC为0.864(P<0.05)。临床妊娠患者和非临床妊娠患者的年龄、体重指数、不孕年限、不孕类型、AMH、E_(2)睾酮比较,差异无统计学意义(P>0.05)。结论血清AMH和E_(2)水平对不孕症患者卵巢储备功能降低有一定的预测价值,血清AMH对卵巢低反应也有一定的预测价值,但血清AMH和E_(2)在预测妊娠结局方面无显著价值。Objective To explore the predictive value of serum anti-Müllerian hormone(AMH)and estradiol(E_(2))on ovarian reserve function,ovarian function and pregnancy outcome after dehydroepiandrosterone(DHEA)treatment.Methods A total of 108 cases of infertility patients admitted in Suzhou Ninth People′s Hospital from July 2020 to June 2022 were selected as study objects,and all the patients were treated with DHEA.The serum AMH and E_(2) levels were compared between patients with decreased ovarian reserve functions and low ovarian response and normal patients.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum AMH and E_(2) on decreased ovarian reserve function and serum AMH on low ovarian response.The clinical data of patients with different pregnant outcomes was compared.Results Serum AMH of patients with reduced ovarian reserve function were significantly lower than those of patients with normal ovarian reserve function(P<0.05),and their E_(2) were higher than those of normal patients(P<0.05).The area under the curve(AUC)of ROC curve of serum AMH and E_(2) in predicting decreased ovarian reserve function were 0.805 and 0.775,respectively(P<0.05).The serum AMH of patients with low ovarian response was lower than that of patients with normal ovarian response(P<0.05).The AUC of the ROC curve of serum AMH in predicting low ovarian response was 0.864(P<0.05).Comparison of the age,body mass index,infertility duration,infertility types,AMH,E_(2) and testosterone between clinical pregnant and non-pregnant patients showed no statistical significance(P>0.05).Conclusions Serum AMH and E_(2) levels have certain predictive value in the decreased reproductive reserve function of infertility patients,and serum AMH has certain value in predicting low ovarian response.However,serum AMH and E_(2) have no significant value in predicting pregnancy outcomes.

关 键 词：不孕症 抗米勒管激素 雌二醇 脱氢表雄酮 卵巢功能 

分 类 号：R711[医药卫生—妇产科学]