超促排卵过程中抗苗勒管激素动态变化及其与临床结局的相关性

发布时间：2018-01-17 23:06

本文关键词：超促排卵过程中抗苗勒管激素动态变化及其与临床结局的相关性　出处：《中华生殖与避孕杂志》2017年02期 　论文类型：期刊论文

【摘要】：目的探讨血清及卵泡液(follicular fluid,FF)中抗苗勒管激素(AMH)在控制性超促排卵(COH)过程中的动态变化及其与COH结局的相关性分析。方法选取因输卵管因素和/或男方因素行体外受精/卵胞质内单精子注射-胚胎移植(IVF/ICSI-ET)的周期,随机分为长方案组(n=38)和非降调节组(n=38)。长方案组和非降调节组分别于前一月经周期第2或第3日(基础日)、降调节期间月经第2或第3日、促性腺激素(Gn)启动日、Gn启动第5日(Gn5)、诱发排卵日(h CG注射日)、取卵前1日和取卵后3 d抽取外周静脉血。取卵日收集直径≥18 mm(大)、14~17 mm(中)、14 mm(小)的FF。结果降调节后血清AMH水平在Gn启动日较基础日显著升高,2种COH方案随外源性Gn使用时间的增加血清AMH降低;随卵泡直径增大,FF中AMH降低。Gn5血清AMH与获卵数、MⅡ卵数和可利用胚胎数相关性最强,中FF的AMH与窦卵泡数(AFC)、Gn用量和可利用胚胎相关性较好。结论降调节显著升高AMH水平,增加可募集AFC及改善卵泡发育同步化,提示可依此调整Gn用量,外源性Gn使用后AMH水平逐渐降低;Gn5血清AMH水平可预测IVF/ICSI-ET结局。
[Abstract]:Objective to investigate follicular fluid in serum and follicular fluid. The role of AMH in controlled hyperstimulation of ovulation (COH). Methods in vitro fertilization / intracytoplasmic sperm injection (IVF) / intracytoplasmic sperm injection (ICSI) and embryo transfer (EIT) were performed by tubal and / or male factors. The cycle of IVF / ICSI-ETS. The long plan group and the non-descending regulation group were randomly divided into two groups: the long plan group and the non-descending regulation group on the second or 3rd of the previous menstrual cycle (base day). On the 2nd or the 3rd of menstruation, the gonadotropin Gn was initiated on the 5th (Gn5) and induced ovulation on the day of CG injection). Peripheral venous blood was collected on 1st before and 3 days after oviposition. The diameter of the blood collected on the day of oocyte collection was more than 18 mm (1417 mm (middle)). Results the level of serum AMH increased significantly at the start day of Gn compared with the baseline day. The levels of serum AMH decreased with the increase of exogenous Gn use time. With the increase of follicular diameter, the level of AMH in FF decreased. Gn5 serum AMH was significantly correlated with the number of eggs obtained and the number of available embryos. The AMH of FF was correlated with the number of antral follicles. Conclusion descending regulation can significantly increase the level of AMH, increase the recruitment of AFC and improve the synchronization of follicle development, suggesting that the dosage of Gn can be adjusted accordingly. The level of AMH decreased gradually after exogenous Gn treatment. The serum AMH level of Gn5 can predict the outcome of IVF/ICSI-ET.
【作者单位】：河北医科大学研究生院;解放军白求恩国际和平医院;
【分类号】：R714.8
【正文快照】： 和平医院(吴小华)血清抗苗勒管激素(anti-Mülleran hormone,AMH)是由2个相对分子质量(70 000)的亚基组成的二聚体糖蛋白,是转化生长因子β(transforming growth factorβ,TGF-β)超家族的一员。关于AMH在控制性超促排卵(controlled ovarian hyperstimulation,COH)过程中的动

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