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目的探讨抗苗勒氏管激素(AMH)在辅助生殖技术(ART)中对控制性超排卵(COH)卵巢低反应的预测价值。方法利用ELISA法对181例首次接受IVF/ICSI-ET治疗的不孕症患者基础血清AMH蛋白水平(bAMH)进行检测。根据患者COH卵巢反应将患者分为2组:卵巢低反应组20例(获卵数≤5个)和卵巢反应良好组161例(获卵数>5个)。比较bAMH与年龄、获卵数、基础FSH等的相关性。结果①181例不孕症患者bAMH水平与获卵数呈显著正相关(r=0.709,P<0.05);②卵巢低反应组(获卵数≤5个)与反应良好组(获卵数>5个)的bAMH水平比较,差异有统计学意义(P<0.05);③受试者工作特征(ROC)曲线分析显示,bAMH水平的曲线下面积(AUC)为0.949。当bAMH截断值≤3.65ng/ml时,灵敏度为86.3%,特异度为90.0%。结论 AMH与卵巢反应性有关,可以在辅助生殖技术中作为评价预测COH中卵巢低反应的血清学标记物。
Objective To investigate the predictive value of anti-Müllerian hormone (AMH) in ovarian response to controlled ovarian hyperstimulation (COH) in assisted reproductive technology (ART). Methods The basal serum AMH protein level (bAMH) in 181 infertile patients treated with IVF / ICSI-ET for the first time was detected by ELISA. The patients were divided into two groups according to their COH ovarian response: 20 cases of ovarian low response (≤5 oocytes) and 161 cases of ovarian response (oocytes retrieved> 5). The correlation between bAMH and age, number of oocytes retrieved, basal FSH, etc. was compared. Results ① There was a significant positive correlation between bAMH level and the number of oocytes retrieved (P = 0.709, P0.05) in 181 infertility patients; ② The number of oocytes retrieved in the ovarian low response group (P <0.05). ③The ROC curves of subjects showed that the area under the curve of bAMH level (AUC) was 0.949. Sensitivity was 86.3% and specificity was 90.0% when bAMH cut-off was ≤3.65 ng / ml. Conclusions AMH is associated with ovarian reactivity and can be used as a serological marker in predicting ovarian hyporesponsiveness in COH in assisted reproductive technology.