首都医科大学学报
首都醫科大學學報
수도의과대학학보
JOURNAL OF CAPITAL UNIVERSITY OF MEDICAL SCIENCES
2014年
4期
402-406
,共5页
李莹%聂明月%方颖%杨晓葵
李瑩%聶明月%方穎%楊曉葵
리형%섭명월%방영%양효규
多囊卵巢综合征%控制性超促排卵%抗苗勒管激素%抑制素B
多囊卵巢綜閤徵%控製性超促排卵%抗苗勒管激素%抑製素B
다낭란소종합정%공제성초촉배란%항묘륵관격소%억제소B
polycystic ovarian syndrome(PCOS)%controlled ovarian hyperstimulation(COH )%anti-Müllerian hormone( AMH )%inhibin B(INHB)
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-Müllerian 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E 2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。
目的：探討多囊卵巢綜閤徵（ polycystic ovarian syndrome ， PCOS ）患者控製性超促排卵（ controlled ovarian hyperstimulation，COH）過程中血清抗苗勒管激素（anti-Müllerian hormone，AMH）和抑製素B（inhibin B，INHB）濃度的變化及其對COH結跼的預測價值。方法 PCOS 組患者37例，對照組患者41例。檢測患者月經週期第2/3天（ D2/3）、促性腺激素（gonadotrophin，Gn）刺激第5天（D5）、人絨毛膜促性腺激素（human chorionic gonadotropin，hCG）日（D-hCG）血清AMH及INHB濃度及取卵日卵泡液中AMH及INHB濃度，觀察其動態變化及其對COH結跼的影響。結果在COH過程中，血清AMH濃度逐漸降低，而血清INHB濃度逐漸升高。 PCOS組患者hCG日血清雌二醇（ estrodiol，E2）濃度、穫卵數、冷凍胚胎數較對照組明顯升高（P＜0．05，P＜0．001），而Gn用量、受精率均低于對照組，差異有統計學意義（P＜0．05），2組患者的臨床妊娠率比較，差異無統計學意義（P＞0．05）。血清AMH和INHB濃度與Gn劑量、hCG日E 2濃度具有相關性（P＜0．05，P＜0．001），但是與穫卵數、臨床妊娠率無相關性（P＞0．05）。結論 PCOS患者 AMH和INHB濃度在COH過程中呈現動態變化，可以預測COH中卵巢的反應性，但是對超促排卵結跼的預測價值還有待進一步研究。
목적：탐토다낭란소종합정（ polycystic ovarian syndrome ， PCOS ）환자공제성초촉배란（ controlled ovarian hyperstimulation，COH）과정중혈청항묘륵관격소（anti-Müllerian hormone，AMH）화억제소B（inhibin B，INHB）농도적변화급기대COH결국적예측개치。방법 PCOS 조환자37례，대조조환자41례。검측환자월경주기제2/3천（ D2/3）、촉성선격소（gonadotrophin，Gn）자격제5천（D5）、인융모막촉성선격소（human chorionic gonadotropin，hCG）일（D-hCG）혈청AMH급INHB농도급취란일란포액중AMH급INHB농도，관찰기동태변화급기대COH결국적영향。결과재COH과정중，혈청AMH농도축점강저，이혈청INHB농도축점승고。 PCOS조환자hCG일혈청자이순（ estrodiol，E2）농도、획란수、냉동배태수교대조조명현승고（P＜0．05，P＜0．001），이Gn용량、수정솔균저우대조조，차이유통계학의의（P＜0．05），2조환자적림상임신솔비교，차이무통계학의의（P＞0．05）。혈청AMH화INHB농도여Gn제량、hCG일E 2농도구유상관성（P＜0．05，P＜0．001），단시여획란수、림상임신솔무상관성（P＞0．05）。결론 PCOS환자 AMH화INHB농도재COH과정중정현동태변화，가이예측COH중란소적반응성，단시대초촉배란결국적예측개치환유대진일보연구。
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 .Rseults (1) AMH levels gradually decreased while INHB levels gradually increased from D 2/3to 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 D 2/3, 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 .
