【摘要】 目的 探讨抗苗勒管激素（anti-Müllerianhormone, AMH）对多囊卵巢综合征（polycystic ovary syndrome, PCOS）患者行体外受精/卵胞浆内单精子注射-胚胎移植（in-vitro fertilization/intracytoplasmic single sperm injection-embryo transplantation, IVF/ICSI-ET）控制性促排卵和妊娠结果的影响。方法 回顾性分析行IVF/ICSI-ET助孕治疗的608例PCOS患者，依据血清AMH四分位数分为3组，低AMH水平组：AMH水平<7.08 pg·L^-1,152例；中AMH水平组：AMH水平7.08～14.81 pg·L^-1,304例；高AMH水平组：AMH水平>14.81 pg·L^-1,152例。比较3组患者的一般资料、控制性促排卵情况及助孕结局。结果 高AMH水平组PCOS患者黄体生成素/卵泡刺激素（luteinizing hormone/follicle stimulating hormone, LH/FSH）比值、基础血清LH、雌二醇（estradiol, E₂）、睾酮（testosterone, T）水平、AMH、窦卵泡计数（antral follicle count, AFC）、平均获卵数、平均受精数、可利用胚胎数、卵巢过度刺激综合征（ovarian hyperstimulation syndrome, OHSS）高危风险率显著性高于低、中AMH水平组；中AMH水平组基础窦卵泡数、平均获卵数、平均受精数、可利用胚胎数高于低AMH水平组，差异有统计学意义（P<0.05）;高AMH水平组PCOS患者体质量指数（body mass index, BMI）、基础血清FSH及Gn启动量低于低AMH水平组，差异有统计学意义（P<0.05）;多因素logistic回归分析显示，AMH是OHSS高危风险的影响因素（P<0.05）;3组患者间临床妊娠率、着床率、生化妊娠率、流产率及活产率比较，差异均无统计学意义（P>0.05）。结论 血清AMH值可反映PCOS患者行IVF-ET过程中的临床特征，预测PCOS患者IVF-ET控制性促排卵周期卵巢反应性，但不能预测IVF-ET后的妊娠结果。更多还原

【Abstract】 Objective To investigate the association of anti-Müllerianhormone（AMH） with controlled ovulation and pregnancy outcomes in polycystic ovary syndrome（PCOS） patients undergoing in-vitro fertilization/intracytoplasmic single sperm injection-embryo transplantation（IVF/ICSI-ET）. Methods The 608 patients with PCOS treated with IVF/ICSI-ET were retrospectively analyzed and divided into three groups according to serum AMH quartiles: low AMH level group(AMH level <7.08 pg·L^-1, 152 cases), medium AMH level group(AMH level 7.08～14.81 pg·L^-1, 304 cases) and high AMH level group(AMH level>14.81 pg·L^-1, 152 cases). The general information, the situation of controlled ovulation induction and the outcome of assisted pregnancy were compared among the three groups. Results Luteinizing hormone/follicle stimulating hormone（LH/FSH） ratio, basal serum LH, estradiol（E₂）, testosterone（T） levels, AMH, antral follicle count（AFC）, mean number of eggs gained, mean number of eggs fertilized, number of available embryos, and risk of ovarian hyperstimulation syndrome（OHSS） were significantly higher in PCOS patients with high AMH levels than in those with low and medium AMH levels（P<0.05）. The number of basal sinus follicles, mean number of eggs obtained, mean number of fertilized eggs and number of available embryos were higher in PCOS patients with medium AMH level than in those with low AMH level, with statistically significant differences（P<0.05）. Body mass index（BMI）, basal serum FSH and Gn initiation were significantly lower in the high AMH group than in the low AMH group, with a statistically significant difference（P<0.05）. Multi-factor logistic regression analysis showed that AMH was an influential factor in the high risk of OHSS（P<0.05）. There was no statistically significant difference between the three groups in terms of clinical pregnancy rate, pregnancy placement rate, biochemical pregnancy rate, miscarriage rate and live birth rate（P>0.05）. Conclusion Serum AMH values can reflect the clinical characteristics of PCOS patients undergoing IVF-ET and predict ovarian responsiveness to IVF-ET controlled ovulation cycles in PCOS patients, but do not predict pregnancy outcome after IVF-ET.更多还原