目的 分析多囊卵巢综合征(PCOS)患者进行体外受精-胚胎移植(IVF-ET)超促排卵治疗后,取卵日血清及卵泡液中的抗苗勒氏管激素(AMH)水平与临床结果的关系.方法 选取行IVF-ET患者共64例.分为两组,第1组为PCOS患者(共30例),第2组为对照组患者(共34例).两组患者均使用口服避孕药预处理后的黄体期长方案行IVF-ET治疗.比较两组患者年龄、基础窦状卵泡数、基础性激素水平、Gn的用量、获卵率、优质胚胎率、着床率、临床妊娠率、早期流产率、继续妊娠率与取卵日血清及卵泡液中AMH水平的关系.取卵日血清及卵泡液中AMH的测定采用美国DSL公司ELISA试剂盒.结果 PCOS组与对照组患者年龄、基础性激素水平、优质胚胎率、着床率、临床妊娠率、早期流产率、继续妊娠率等差异无统计学意义(P＞0.05).PCOS组基础窦状卵泡数显著多于对照组、Gn的用量少于对照组、获卵率低于对照组,卵泡液与血清中的AMH水平PCOS组高于对照组,差异有统计学意义(P＜0.05).两组中妊娠患者血清与卵泡液中的AMH水平显著增高,与未妊娠患者比较差异均有统计学意义(P＜0.05).结论 取卵日血清及卵泡液AMH水平能预测PCOS患者的IVF周期超促排卵结果,但是不能预测PCOS患者TVF-ET后的妊娠结果.%Objective To investigate the association of anti-Müllerian hormone (AMH) levels in the follicular fluid and serum with the outcomes of in vitro fertilization-embryo transfer (IVF-ET) cycles in patients with polycystic ovarian syndrome (PCOS). Methods Serum and follicular fluid samples were obtained from 30 patients with PCOS and 34 healthy women (control) undergoing IVF/ICSI-ET in our center between October, 2007 and January, 2008. All the subjects received treatment with long luteal-phase down-regulation and controlled ovarian hyperstimulation protocol in IVF cycles, and their clinical characteristics were analyzed. The AMH levels in the serum and follicles fluid samples collected on the day of oocyte retrieval were assayed using an enzyme-linked immunosorbent assay (ELISA) kit. Results The two groups showed no significant differences in the mean age, baseline levels of sex hormones, rate of high-quality embryos, implantation rate, pregnancy rate, abortion rate or ongoing pregnancy rate (PXD.05). Despite a significantly lower total gonadotropin dose, PCOS group had a significantly greater number of antral follicles than the control group (P0.05). The recovery rates of oocytes in PCOS group were significantly lower than that in the control group (P0.05). AMH levels in the serum and follicle fluid was significantly higher in PCOS group than in the control group (P0.05), and in both groups, AMH levels in the follicular fluid were significantly higher in pregnant women than in non-pregnant women (P0.05). AMH level in the follicular fluid was significantly correlated with the implantation rate in both PCOS and control groups (P0.05). Conclusion AMH level in the serum and follicle fluid on the day of oocyte retrieval is predictive of the treatment outcome of controlled ovarian hyperstimulation in POCS patients but not of pregnancy outcomes after IVF-ET.
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