多囊卵巢综合征患者控制性超促排卵过程AMH和INHB浓度变化的临床研究

doi:10.3969/j.issn.1006-7795.2014.04.004

首都医科大学学报 ›› 2014, Vol. 35 ›› Issue (4): 402-406.doi: 10.3969/j.issn.1006-7795.2014.04.004

• 更年期与妇科内分泌专题 • 上一篇下一篇

多囊卵巢综合征患者控制性超促排卵过程AMH和INHB浓度变化的临床研究

李莹, 聂明月, 方颖, 杨晓葵

首都医科大学附属北京妇产医院生殖医学科, 北京 100026

收稿日期:2014-06-10 出版日期:2014-08-21 发布日期:2014-07-22
通讯作者: 杨晓葵 E-mail:xiaokuiyang2012@163.com
基金资助:
国家自然科学基金项目（81170542），北京市卫生系统高层次技术人才培养项目（2011-3-071），首都医科大学附属北京妇产医院、北京妇幼保健院学科带头人项目（2013-2）。

Changes of anti-Mullerian hormone（AMH） and inhibin B（INHB） during controlled ovarian hyperstimulation in polycystic ovarian syndrome

Li Ying, Nie Mingyue, Fang Ying, Yang Xiaokui

Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, 100026

Received:2014-06-10 Online:2014-08-21 Published:2014-07-22
Supported by:
This study was supported by Natural Science Foundation of China(81170542); Beijing Municipality Health Technology High-level Taltent(2011-3-071); Project of Discipline Leader, Beijing Obstetrics and Gynecology Hospital, Capital Medical University(2013-2).

摘要/Abstract

摘要：

目的探讨多囊卵巢综合征（polycystic ovarian syndrome，PCOS）患者控制性超促排卵（controlled ovarian hyperstimulation，COH）过程中血清抗苗勒管激素（anti-Mü；llerian hormone，AMH）和抑制素B（inhibin B，INHB）浓度的变化及其对COH结局的预测价值。方法 PCOS组患者37例，对照组患者41例。检测患者月经周期第2/3天（D2/3）、促性腺激素（gonadotrophin，Gn）刺激第5天（D5）、人绒毛膜促性腺激素（human chorionic gonadotropin，hCG）日（D-hCG）血清AMH及INHB浓度及取卵日卵泡液中AMH及INHB浓度，观察其动态变化及其对COH结局的影响。结果在COH过程中，血清AMH浓度逐渐降低，而血清INHB浓度逐渐升高。PCOS组患者hCG日血清雌二醇（estrodiol，E₂）浓度、获卵数、冷冻胚胎数较对照组明显升高（P<0.05，P<0.001），而Gn用量、受精率均低于对照组，差异有统计学意义（P<0.05），2组患者的临床妊娠率比较，差异无统计学意义（P>0.05）。血清AMH和INHB浓度与Gn剂量、hCG日E₂浓度具有相关性（P<0.05，P<0.001），但是与获卵数、临床妊娠率无相关性（P>0.05）。结论 PCOS患者AMH和INHB浓度在COH过程中呈现动态变化，可以预测COH中卵巢的反应性，但是对超促排卵结局的预测价值还有待进一步研究。

关键词: 多囊卵巢综合征, 控制性超促排卵, 抗苗勒管激素, 抑制素B

Abstract:

Objective To explore dynamics of anti-Müllerian hormone(AMH) and inhibin B(INHB) during controlled ovarian hyperstimulation(COH) in polycystic ovarian syndrome(PCOS), and assess the value of these dynamic changes on the prediction of outcome in PCOS patients undergoing in vitro fertilization(IVF). Methods Thirty-seven women with PCOS and 41 women with normal ovarian reserve as the control were recruited in the study. AMH and INHB levels were measured in serum on menstrual cycle day 2 or 3(D2/3), day 5 of gonadotropin stimulation(D5), human chorionic gonadotropin(hCG) day (D-hCG) and follicular fluid(FF) on oocyte retrieval day during IVF treatment, and the relationship of AMH and INHB levels with COH outcomes was analyzed. Results (1) AMH levels gradually decreased while INHB levels gradually increased from D2/3 to D-hCG during COH procedure. (2) Significant differences were observed in estradiol(E2) levels of hCG day, gonadotrophin(Gn) dosage, retrieved oocytes, fertilization rate and frozen embryos(P<0.05) in PCOS and control groups. (3) There was a negative correlation in serum AMH and INHB levels on D2/3, D5 and D-hCG with Gn dosage, positive correlation with estradiol of hCG day(P<0.05, P<0.001), no correlation with oocytes retrieval and clinical pregnancy rate(P>0.05). Conclusion Serum AMH and INHB levels are demonstrated to have dynamic changes during COH procedure in PCOS patients, and reflect the ovarian response in COH. The predictive value of AMH and INHB on COH outcomes in PCOS remains to be evaluated via further research.

Key words: polycystic ovarian syndrome(PCOS), controlled ovarian hyperstimulation(COH), anti-Mü, llerian hormone(AMH), inhibin B(INHB)

中图分类号:

R711.75

李莹, 聂明月, 方颖, 杨晓葵. 多囊卵巢综合征患者控制性超促排卵过程AMH和INHB浓度变化的临床研究[J]. 首都医科大学学报, 2014, 35(4): 402-406.

Li Ying, Nie Mingyue, Fang Ying, Yang Xiaokui. Changes of anti-Mullerian hormone（AMH） and inhibin B（INHB） during controlled ovarian hyperstimulation in polycystic ovarian syndrome[J]. Journal of Capital Medical University, 2014, 35(4): 402-406.

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多囊卵巢综合征患者控制性超促排卵过程AMH和INHB浓度变化的临床研究

Changes of anti-Mullerian hormone（AMH） and inhibin B（INHB） during controlled ovarian hyperstimulation in polycystic ovarian syndrome

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