AMH過高或過低均會影響卵子之品質與數量

AMH過高(>4.5) 或過低(<1.7)均會影響卵子之品質與數量

最佳AMH數值為1.7-4.5

http://humrep.oxfordjournals.org/content/21/8/2022.full

Basal level of anti-Müllerian hormone is associated with oocyte quality in stimulated cycles

1. T. Ebner¹,³, 
2. M. Sommergruber¹, 
3. M. Moser¹, 
4. O. Shebl¹,
5. E. Schreier-Lechner² and 
6. G. Tews¹

+Author Affiliations

1. ¹IVF-Unit, Landes- Frauen- und Kinderklinik, Linz, Austria and
2. ²Department of Laboratory Medicine, Landes- Frauen- und Kinderklinik, Linz, Austria

1. 3To whom correspondence should be addressed at: IVF-Unit, Landes- Frauen- und Kinderklinik, Krankenhausstraße 26-30, A-4020 Linz, Austria. E-mail:thomas.ebner@gespag.at

• Received February 17, 2006.
• Revision received March 21, 2006.
• Accepted March 28, 2006.

 

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Abstract

BACKGROUND: Serum anti-Müllerian hormone (AMH) levels provide a powerful means for predicting ovarian response, which is reflected not only by the size of the primordial follicle pool but also by the quality of the oocytes. Considering a mutual interdependence between AMH-expressing somatic cells and gametes, this prospective morphological study was set up to evaluate whether extreme AMH levels represent diminished oocyte quality and developmental incompetence. METHODS: A total of 141 consecutive ICSI patients were subdivided into three groups using the 25th and 75th percentiles of the serum AMH levels (cycle day 3). In these three groups, morphology of all oocytes and fertilization rate, embryo quality and blastocyst formation were evaluated, and FSH, LH and estradiol (E₂) levels were also measured. RESULTS: Cycle cancellation rate was correlated with AMH levels (P < 0.05). AMH groups 1 (<1.66 ng/ml) and 3 (>4.52 ng/ml) showed oocytes of lower quality [dark central granulation, aggregation of smooth endoplasmic reticulum (sER)] compared with the median group 2 (1.66–4.52 ng/ml). Basal serum FSH did not allow for adequate prognosis in terms of gamete appearance. Fertilization and further cleavage up to blastocyst stage was not affected by AMH levels. CONCLUSIONS: AMH seems to be superior to FSH in predicting both oocyte number and quality.

Key words

• AMH
 
• central granulation
 
• cycle cancellation
 
• FSH
 
• oocyte quality

Table II.

Number and quality of oocytes with respect to anti-Müllerian hormone (AMH) group affiliation

	Group 1 (AMH <1.66)	Group 2 (AMH 1.66–4.52)	Group 3 (AMH >4.52)
Number of oocytes	155	627	462
MII	139 (89.7)	538 (85.8)	390 (84.4)
Normal oocytes	47 (33.8)	242 (45.0)***	139 (35.6)
Anomalies	92 (66.2)	296 (55.0)	251 (64.4)
Central granulation	43 (46.7)***	88 (29.7)	75 (29.9)
Vacuolization	9 (9.8)	39 (13.2)**	13 (5.2)
Aggregation sER	4 (4.4)	5 (1.7)**	16 (6.4)
Incorporation	14 (15.2)****	61 (20.6)	85 (33.8)
Refractile body	7 (7.6)	77 (26.0)***	39 (15.5)
PVS granula	7 (7.6)	13 (4.4)	8 (3.2)
Multiple anomalies	8 (8.7)	13 (4.4)	15 (6.0)

• MII, metaphase II; PVS, perivitelline space; sER, smooth endoplasmic reticulum.
• ↵* P < 0.05 versus group 1, **P < 0.01 versus group 3, ***P < 0.01 versus other groups, ****P < 0.001 versus other groups.