摘要
目的探讨卵巢多囊样改变(polycystic ovarian morphology,PCOM)合并不孕症患者体外受精-胚胎移植中抗苗勒管激素(anti-Müllerian hormone,AMH)水平对卵母细胞发育潜能的影响。方法选取符合纳入与排除标准的不孕症患者480例(对照组160例、PCOM组104例、PCOS组216例),比较不同组间AMH水平。PCOM及PCOS人群均按血清AMH水平(≤4.7ng/ml为正常值,>4.7ng/ml为高值)分为正常AMH组和高AMH组,分析PCOM及PCOS人群不同AMH水平组间的卵母细胞指标差异及其相关性。结果PCOS人群血清基础雄激素高于PCOM人群(P<0.01);血清AMH水平比较:对照组<PCOM组<PCOS组(P<0.001);实验室指标分析结果显示,PCOM及PCOS人群高AMH组成熟卵数、2PN数、受精数、D3卵裂数及胚胎总数较正常AMH组增多(P<0.05),且AMH水平与成熟卵数、2PN数、受精数、D3卵裂数、胚胎总数均呈正相关(P<0.05);PCOS人群高AMH组优势卵泡数、获卵数、优胚数及可利用胚胎数较正常AMH组增多(P<0.05),且AMH水平与优势卵泡数、获卵数、优胚数及可利用胚胎数均呈正相关(P<0.05),但PCOM人群中不同AMH水平组间的上述指标比较,差异无统计学意义(P>0.05)。结论PCOM合并不孕症人群血清AMH水平较对照组升高但低于PCOS人群,高AMH水平的PCOM患者可获得质量较好的卵母细胞及更多的胚胎,增加临床中反复移植失败患者移植次数,提高临床妊娠率。
Objective To investigate the effect of anti-Müllerian hormone(AMH)levels on the development potential of oocytes in patients with polycystic ovarian morphology(PCOM)complicated with infertility during in vitro fertilization-embryo transfer.Methods A total of 480 infertile patients who met the inclusion and exclusion criteria were selected(160 cases in control group,104 cases in PCOM group and 216 cases in PCOS group),AMH levels were compared among different groups.According to the serum AMH level(≤4.7ng/ml as normal value,>4.7ng/ml as high value),both PCOM and PCOS patients were divided into normal AMH group and high AMH group.The differences of oocyte indexes and their correlation between different AMH levels in PCOM and PCOS patients were analyzed.Results The basal androgen level in PCOS group was significantly higher than that in PCOM group(P<0.01).The comparison of serum AMH value showed that the control group<PCOM group<PCOS group(P<0.001).Laboratory indexes showed that the number of mature oocytes,2PN,fertilization,D3 cleavage and total embryos in the high AMH group were significantly higher than those in the normal AMH group in PCOM and PCOS patients(P<0.05).The AMH levels was positively correlated with the number of mature oocytes,2PN,fertilization,D3 cleavage and total embryos(P<0.05).In the PCOS group,the number of dominant follicles,oocytes,high-quality embryos and available embryos in the high AMH group were significantly higher than those in the normal AMH group(P<0.05),and the AMH levels was positively correlated with the number of dominant follicles,oocytes,high-quality embryos and available embryos(P<0.05).However,there was no significant difference in the above indicators among different AMH levels in PCOM group(P>0.05).Conclusion The serum AMH level of PCOM patients with infertility is higher than that of the control group,but lower than that of PCOS patients.PCOM patients with high AMH level can obtain better quality oocytes and more embryos,and increase the number of transplantation in patients with repeated transplantation failure,thereby improving the clinical pregnancy rate.
作者
李雪敏
杨贵芳
田珏
郭瑞霞
杨晓丽
LI Xuemin;YANG Guifang;TIAN Jue(The Ninth Clinical Medical College of Shanxi Medical University(Taiyuan Central Hospital),Shanxi 030009,China)
出处
《医学研究杂志》
2024年第2期81-85,共5页
Journal of Medical Research
基金
山西省医学重点科研计划项目重大科技攻关专项(2020XM09)
山西省省筹资金资助回国留学人员科研项目(2021-175)
山西省研究生教育创新项目(2021Y400)。
关键词
抗苗勒管激素
体外受精-胚胎移植
卵巢多囊样改变
多囊卵巢综合征
卵母细胞发育潜能
Anti-Müllerian hormone
In vitro fertilization-embryo transfer
Polycystic ovarian morphology
Polycystic ovary syndrome
Oocyte developmental potential
