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Objective:To explore the relationship between serum anti-Müllerian hormone (AMH) level and related clinical factors in healthy females, and establish and validate equation of correlation between age and serum AMH level for healthy females.Methods:From March 2015 to December 2016, a total of 602 females who measured serum AMH level in Department of Nuclear Medicine, the Second Affiliated Hospital of Soochow University were retrospectively enrolled. All cases had relatively complete clinical data, and were divided into healthy group (484 cases, 20-52 years) and case group (118 cases, 20-42 years; patients with menstrual disorders). Relationships between serum AMH level and estradiol (E2), tesosterone (T), follicle stimulating hormone (FSH), luetinizing hormone (LH), body mass index (BMI) of healthy group were analyzed by Spearman rank correlation. Kruskal-Wallis rank sum test was used to analyze the relationship between history of gestation and serum AMH level. Serum AMH level of health group was processed to establish predictive equation for serum AMH level. Internal ( n=27) and external ( n=37) validation group were chosen from healthy females with serum AMH level measured to validate the equation, and signed rank test was used to analyze the data. Difference between serum AMH level in case group and healthy group with corresponding age was explored by independent-sample t test. Results:Serum AMH levels were positively correlated with E2 and T ( rs values: 0.263, 0.334, both P<0.001), and negatively correlated with FSH, LH, BMI ( rs values: from -0.515 to -0.110, all P<0.005). Predictive equation was established as LogAMH=-1.208+ 0.1×age-0.000 042×age 3 ( R2=0.735, P<0.001). No statistically significant difference was found between real serum AMH levels and calculated serum AMH levels in the internal and external validation groups ( z values: -1.62 and -1.52, both P>0.05). Females in case group ( n=118) and control group ( n=446) were divided into two sub-groups respectively (<35 years and ≥35 years), and serum AMH levels of case group were lower than those of control group with corresponding age ( t values: 18.64, 11.70, both P<0.001). Conclusions:In healthy females, serum AMH level is related to some clinical data. The equation between serum AMH level and age established in the study may provide reference for clinical diagnosis and treatment.
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Objective:To investigate the efficacy of gonadotropin releasing hormone agonist (GnRH-a) combined with a levonorgestrel-releasing intrauterine system (Mirena) in patients with adenomyosis and its effects on ovarian function, carbohydrate antigen (CA) 125, CA153 and carcino-embryonic antigen (CEA) expression.Methods:Seventy-eight patients with adenomyosis who received treatment from September 2017 to September 2020 in Shaoxing People's Hospital were included in this study. They were randomly divided into treatment and control groups ( n = 39/group). Patients in the control group were treated with a levonorgestrel-releasing intrauterine system. Patients in the treatment group were treated with GnRH-a, once per month in the first 3 months based on treatment with a levonorgestrel-releasing intrauterine system. After 6 months of treatment, changes in dysmenorrheal relief, menstrual volume, uterine volume, endometrial thickness, ovarian function, CA125, CA153 and CEA levels relative to before treatment were compared. Results:Visual analog scale score and pictorial blood assessment chart score in the treatment group were (1.36 ± 0.28) points and (38.98 ± 5.42) points, which were significantly lower than those in the control group [(1.78 ± 0.31) points, (63.42 ± 6.75) points, t = 6.27, 17.63, both P < 0.05). Uterine volume and endometrial thickness in the treatment group were (209.74 ± 15.65) cm 3 and (7.37 ± 0.57) mm, respectively, which were significantly lower than those in the control group [(278.39 ± 20.90) cm 3, (8.63 ± 0.86) mm, t = 16.45, 7.62, P < 0.05]. There were no significant differences in serum levels of luteinizing hormone, follicle stimulating hormone and estradiol between the two groups (all P > 0.05). Serum CA125, CA153 and CEA levels in the treatment group were (26.87 ± 7.21) U/L, (23.12 ± 7.38) U/mL and (5.45 ± 0.96) μg/L, respectively, which were significantly lower than those in the control group [(49.93 ± 8.97) U/L, (38.94 ± 6.21) U/mL, (8.23 ± 1.35) μg/L, t = 12.51,10.24,10.48, P < 0.05]. Conclusion:GnRH-a combined with a levonorgestrel-releasing intrauterine system (Mirena) can markedly relieve dysmenorrhea, reduce menstrual volume, uterine volume, and endometrial thickness, has no obvious effects on ovarian function, and greatly reduce the levels of CA125, CA153 and CEA. Therefore, the combined method is a safe and effective non-surgical treatment method of adenomyosis.
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Anti-Müllerian hormone (AMH),a dimer glycoprotein secreted by sustentacular cells of testis and ovarian granulosa cells,belonging to the transforming growth factor β super-family.AMH is able to regulate follicular development and participate in follicular growth process,and it is relatively constant throughout the menstrual cycle compared with other ovarian reserve indicators.At present,AMH is widely used to evaluate ovarian reserve and to diagnose and evaluate the development and prognosis of ovarian diseases.It has been increasingly applied in the field of female assisted reproduction in recent years.With the development of detection technology,the sensitivity and accuracy of methods for detecting AMH are gradually improved.This review summarizes the research background,mechanism of action,clinical applications and detecting methods of AMH.
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Objective To evaluate the effect of anti-Mueller hormone on ovarian reserve in female patients with systemic lupus erythematosus(SLE).Methods The clinical data of 80 women with SLE in the Department of Rheumatism of Zaozhuang Municipal Hospital from June 2015 to June 2018 were collected.The patients used cyclophosphamide before entering the group were selected as A group (35 cases),and patients who didn't use cyclophosphamide were selected as B group(45 cases),and 30 healthy female volunteers were selected as the control group at the same time.All of them were normal menstrual cycle.At the third day of the menstrual cycle,the levels of anti-Mueller hormones were detected by enzyme linked immunosorbent assay.The serum levels of estrogen and alveolar hormone were detected by microparticle enzyme immunoassay,and the number of ovarian sinus follicles in each group was recorded by transvaginal ultrasound.Results The incidence rate of thrombocytopenia,nephritis,hemolytic anemia and neuropsychiatric manifestations in A group were 54.29％ (19/35),85.71％ (30/35),37.14％ (13/35) and 22.86％ (8/35),respectively,which were significantly higher than those in B group [48.89％ (22/45),53.33％ (24/45),13.33％ (6/45),0.00％ (0/45)] (x2 =6.33,9.41,6.16,9.03,all P ＜0.05).The number of anti-Mueller hormone [(1.09 ± 0.33) g/L] and numbers of ovarian sinus follicle [(8 ± 2)] in A group were significantly lower than those in B group [(1.98 ± 0.62) g/L,(12 ± 4)] and control group [(3.37 ± 1.11) g/L,(15 ± 5)],which showed significant differences (F =46.07,25.90,all P ＜ 0.05),but there were no statistically significant differences in serum estrogen and follicular stimulating hormone levels among the three groups(F =1.16,0.97,all P ＞ 0.05).The level of anti-Mueller hormone in patients with SLE aged ＞ 30 years [(0.98 ± 0.31) g/L]was significantly lower than patients ≤30 years old[(1.86 ±0.60) g/L],and the level of anti-Mueller hormone in patients with cyclophosphamide accumulation ＞ 10 g[(0.36 ± 0.11) g/L] was significantly lower than that of 10 g [(1.76 ± 0.52) g/L] (t =7.54,11.30,both P ＜ 0.01).The results of Pearson correlation analysis showed that the anti-Mueller hormone showed negative correlation with the age of SLE and the accumulation of cyclophosphamide (r =-0.56,-0.45,both P ＜ 0.01).Conclusion The use of anti-Mueller hormone has good evaluation value for ovarian reserve function in female patients with SLE,and the level of anti-Mueller hormone is closely related to the age and the accumulation of cyclophosphamide.Therefore,cyclophosphamide should be used carefully in patients who are over 30 years old and the cumulative amount of cyclophosphamide over 10 g.
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Objective@#To investigate the effect of pituitrin-water separation on hemoglobin and ovarian function in laparoscopic ovarian chocolate cyst removal.@*Methods@#From February 2018 to February 2019, 82 patients with ovarian chocolate cyst removed by laparoscopy were selected from the Second Affiliated Hospital of Wenzhou Medical University.They were randomly divided into observation group and control group according to the digital table, with 41 cases in each group.The control group underwent traditional laparoscopic tear-and-tear ovarian cyst removal, while the observation group underwent pituitrin-water separation.The changes of perioperative indicators, the decrease of hemoglobin (Hb) before and after operation, the positive rate of normal ovarian tissue on cyst wall and the number of normal follicles attached to cyst wall, the changes of serum hormone levels before and after operation were compared between the two groups.@*Results@#The amount of bleeding during operation in the observation group [(58.97±8.74)mL] was less than that in the control group [(118.93±24.21)mL], and the operation time in the observation group[(57.46±8.27)min] was shorter than that in the control group [(87.38±10.19)min] , the differences were ststistically significant between the two group(t=14.916, 14.598, all P<0.05). There was no statistically significant difference in the time of anal exhaust between the two groups (P>0.05). The decrease of Hb in the observation group [(0.71±0.16)g/L] was lower than that in the control group [(1.27±0.35)g/L] (t=9.318, P<0.05). The positive rate of normal ovarian tissue on cyst wall in the observation group (21.95%) was lower than that in the control group (56.10%), the number of normal follicles attached to the cyst wall in the observation group (2.65±0.49) was less than that in the control group (4.86±1.24) , the differences were ststistically significant between the two group(χ2=10.045, t=10.613, all P<0.05). The serum level of E2 [(398.21±17.84)pmol/L] in the observation group was higher than that in the control group [(367.83±15.21)pmol/L], while FSH [(6.72±0.28)mIU/mL] and LH [(5.23±0.38)mIU/mL] levels in the observation group were lower than those in the control group [(7.19±0.35)mIU/mL and (5.69±0.31)mIU/mL], the differences were ststistically significant between the two group (t=8.298, 6.714, 6.006, all P<0.05).@*Conclusion@#The method of pituitrin-water separation is effective in laparoscopic ovarian chocolate cyst removal, which can reduce the injury during operation, has little effect on hemoglobin and improve the ovarian reserve function of patients.
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Objective To investigate the effect of pituitrin-water separation on hemoglobin and ovarian func-tion in laparoscopic ovarian chocolate cyst removal.Methods From February 2018 to February 2019,82 patients with ovarian chocolate cyst removed by laparoscopy were selected from the Second Affiliated Hospital of Wenzhou Medical University.They were randomly divided into observation group and control group according to the digital table,with 41 cases in each group.The control group underwent traditional laparoscopic tear-and-tear ovarian cyst removal,while the observation group underwent pituitrin-water separation.The changes of perioperative indicators ,the decrease of hemoglobin (Hb) before and after operation ,the positive rate of normal ovarian tissue on cyst wall and the number of normal follicles attached to cyst wall ,the changes of serum hormone levels before and after operation were compared between the two groups.Results The amount of bleeding during operation in the observation group [(58.97 ±8.74)mL] was less than that in the control group [(118.93 ±24.21)mL],and the operation time in the observation group[(57.46 ±8.27) min] was shorter than that in the control group [(87.38 ±10.19) min] ,the differences were ststistically significant between the two group ( t ＝14.916,14.598,all P ＜0.05 ).There was no statistically significant difference in the time of anal exhaust between the two groups (P＞0.05).The decrease of Hb in the observation group [(0.71 ±0.16)g／L] was lower than that in the control group [(1.27 ±0.35) g／L] ( t＝9.318,P＜0.05).The positive rate of normal ovarian tissue on cyst wall in the observation group (21.95%) was lower than that in the control group (56.10%),the number of normal follicles attached to the cyst wall in the obser-vation group (2.65 ±0.49) was less than that in the control group (4.86 ±1.24) ,the differences were ststistically significant between the two group ( χ2 ＝10.045, t ＝10.613, all P ＜0.05).The serum level of E2 [( 398.21 ± 17.84)pmol／L] in the observation group was higher than that in the control group [(367.83 ±15.21) pmol／L], while FSH [(6.72 ±0.28)mIU／mL] and LH [(5.23 ±0.38)mIU／mL] levels in the observation group were lower than those in the control group [(7.19 ±0.35)mIU／mL and (5.69 ±0.31)mIU／mL],the differences were ststisti-cally significant between the two group (t＝8.298,6.714,6.006,all P＜0.05).Conclusion The method of pitui-trin-water separation is effective in laparoscopic ovarian chocolate cyst removal ,which can reduce the injury during operation,has little effect on hemoglobin and improve the ovarian reserve function of patients .
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Objective To investigate the effect of vasopressin injection technique on ovarian reserve in patients with laparoscopic cystectomy of unilateral ovarian endometrioma .Methods 70 patients with unilateral ovarian endometrioma were randomly allocated into study group (37 cases) and control group(33 cases) according to the digital table .Diluted vasopressin was injected into the space between the normal ovarian cortex and the cyst wall before stripping in the study group , and ordinary laparoscopic cystectomy without injection was adopted in control group.The average contents of anti -mullerian hormone(AMH),follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),antral follicle count(AFC) and peak systolic velocity(PSV) were compared in two groups before and after surgery .Results The operative time of the study group was (37.6 ±8.6) min,which was significantly shorter than (42.8 ±9.1)min of the control group(t=2.46,P<0.05).The blood loss of the study group was (23.2 ±12.1)mL,which was significantly less than (31.4 ±17.3)mL of the control group(t=2.32,P<0.05).In the control group,the E2 levels preoperation and postoperative were (201.46 ±7.51)pmol/L,(153.94 ± 8.72)pmol/L,respectively,the difference was statistically significant between preoperation and postoperation (t =23.72,P<0.05).The AMH levels in the control group preoperation and postoperation were (2.31 ±0.79)ng/mL, (1.67 ±0.75)ng/mL,respectively,there was statistically significant difference between preoperation and postoperation (t=3.38,P<0.05).The FSH levels in the control group preoperation and postoperation were (6.58 ±2.70)U/L, (10.24 ±1.21)U/L,respectively,there was statistically significant difference between preoperation and postoperation (t=7.12,P<0.05).The LH levels in the control group preoperation and postoperation were (5.87 ±1.76)U/L, (6.15 ±2.14) U/L,respectively,there was no significant difference between preoperation and postoperation (t =0.58,P>0.05).The F0 levels in the control group preoperation and postoperation were (8.7 ±2.8),(4.6 ±0.7), respectively,there was significant difference between preoperation and postoperation (P<0.05).The PSV levels in the control group preoperation and postoperation were (13.8 ±5.9)cm/s,(7.5 ±2.4)cm/s,respectively,there was significant difference between preoperation and postoperation (P<0.05).The E2 levels in the study group preopera-tion and postoperation were (199.36 ±8.42)pmol/L,(197.12 ±8.33)pmol/L,respectively,there was no significant difference between preoperation and postoperation (t=1.15,P>0.05).The AMH levels in the study group preopera-tion and postoperation were (2.23 ±0.85) ng/mL,(2.19 ±0.83) ng/mL,respectively,there was no statistically significant difference between preoperation and postoperation (t=0.20,P>0.05).The FSH levels in the study group preoperation and postoperation were (6.27 ±2.35)U/L,(6.73 ±2.23)U/L,respectively,there was no statistically significant difference between preoperation and postoperation (t=0.86,P>0.05).The LH levels in the study group preoperation and postoperation were (5.92 ±2.32) U/L,(5.57 ±2.31) U/L,respectively,there was no statistically significantl difference between preoperation and postoperation (t=0.65,P>0.05).The F0 levels in the study group preoperation and postoperation were (9.2 ±2.4),(8.9 ±2.7),respectively,there was no statistically significant difference between preoperation and postoperation (P>0.05).The PSV levels in the study group preoperation and postoperation were (14.7 ±5.4) cm/s,(14.0 ±4.7) cm/s,respectively,there was no statistically significant difference between preoperation and postoperation (P>0.05).Conclusion Vasopressin injection technique used in unilateral ovarian endometrioma laparoscopic cystectomy is safe and effective ,and it can protect the ovarian reserve .
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Objective To observe the impact of different surgical procedures on ovarian reserve and analge-sic effects of drug use in patients with uterine fibroids.Methods 100 patients with uterine fibroids were randomly divided into two groups.50 patients in control group were implemented traditional open surgery.50 cases in the obser-vation group received laparoscopic myomectomy.The ovarian reserve changes were compared before and after surgery, pain medication use and changes in the degree of pain conditions.Results The levels of follicle stimulating hormone and luteinizing in the control group one,three months after operation were significantly higher than before surgery and the observation group,the level of estrogen was significantly lower than before surgery and observation group,the differences were statistically significant(t=10.23,14.58,9.78,11.76,9.83,9.92,10.07,11.23,all P<0.05).The postoperative first pain time of the observation group was significantly longer than the control group,the difference was statistically significant[(513.74 ±284.52)min vs.(61.38 ±37.21)min,t=92.34,P<0.05].The postoperative analgesic usage of the observation group was significantly lower than the control group,the difference was statistically significant(14.0% vs.58.0%,χ2 =7.83,P<0.05).The pain scores 3d,4d,5d,6d and 7d after operation of the observation group were significantly lower than the control group(t=2.11,2.30,2.58,7.03,6.46,all P<0.05). Conclusion The patients with uterine fibroids laparoscopic myomectomy for treatment will not cause great impact on the patients'ovarian reserve,and can effectively reduce the use of analgesics,and it is worthy of further promotion.
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Abstract Purpose To identify which methods used in the assessment of the ovarian reserve are exclusive or complementary to identify the best response to follicle development. Methods Retrospective cohort study, involving patients undergoing assisted reproduction treatment at the Instituto de Medicina Reprodutiva e Fetal, from April 2009 to July 2014. Age, biochemical tests, and ultrasound were assessed. The data were analyzed to predict the follicular development and the relation between them, using, for statistical analysis, Statistical Package for Social Sciences software. Results Out of the 293 couples included, 50.2% presented infertility by ovarian factor. Considering the age as the main variable, a significant negative correlation with the volume of both ovaries was observed (right ovary, r = 0.21; left ovary, r =0.22; both p< 0.0001), and with the antral follicle count (right ovary, r =0.38; left ovary, r =0.47; both p< 0.0001). Considering the antral follicle count as the main variable, a significant positive correlation with the total recruited oocytes was observed. When we correlated the antral follicle count with the recruited follicles larger than 18 mm, we observed that, with a cutoff of 12 antral follicles, there is a positive predictive value of 99%, and an area under the ROC curve of 0.76. Conclusion We concluded from our study that age and antral follicle count are effective predictors of ovarian response in cycles of assisted reproduction. The ovarian volume, as well as the anti-Müllerian hormone dosage, seem to be adequate markers of the ovarian reserve.
Resumo Objetivo Identificar quais métodos utilizados na avaliação da reserva ovariana são excludentes ou complementares na identificação da melhor resposta ao desenvolvimento folicular. Métodos Estudo retrospectivo de coorte, que envolveu pacientes em tratamento de reprodução assistida no Instituto de Medicina Reprodutiva de abril de 2009 a julho de 2014. Foram avaliadas idade, exames bioquímicos e ecografia. Os dados foram analisados na predição do desenvolvimento folicular e nas suas relações entre si, utilizando para análise estatística o programa Statistical Package for Social Sciences. Resultados Dos 293 casais incluídos, 50,2% apresentavam infertilidade por fator ovariano. Considerando a idade como principal variável, foi observada uma correlação significativa e negativa com volume de ambos ovários (ovário direito, r = 0,21; ovário esquerdo, r =0,22; ambos p< 0,0001), e com contagem de folículos antrais (ovário direito, r =0,38; ovário esquerdo, r =0,47; ambos p< 0,0001). Considerando a contagem de folículos antrais como a variável principal, foi observada uma correlação significativa e positiva com o total de oócitos recrutados. Quando correlacionamos a contagem de folículos antrais com os folículos recrutados maiores do que 18 mm, observamos que, com um ponto de corte de 12 folículos antrais, tem-se um valor preditivo positivo de 99%, e uma área da curva ROC de 0,76. Conclusões Concluímos com nosso trabalho que a idade e a contagem de folículos antrais são eficientes preditores da resposta ovariana em ciclos de reprodução assistida. O volume ovariano, assim como a dosagem do hormônio anti-mulleriano, parecem ser marcadores adequados de reserva ovariana.
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Humans , Female , Adult , Middle Aged , Young Adult , Oocytes , Ovarian Reserve , Ultrasonography , Cohort Studies , Cross-Sectional Studies , Diagnostic Techniques, Obstetrical and Gynecological , Retrospective StudiesABSTRACT
A aferição do hormônio antimülleriano na clínica reprodutiva tem sido realizada com o objetivo de propiciar predição mais fidedigna da reserva folicular ovariana, por ser marcador indireto da quantidade e da qualidade de folículos primordiais. A correlação significativa com a contagem de folículos antrais, a quantidade e a maturidade de oócitos obtidos em técnicas de reprodução assistida têm ficado repetidamente evidentes na literatura, motivo pelo qual, acreditam os autores em um futuro cada vez mais promissor, que o hormônio venha a atuar como marcador propedêutico na avaliação e no prognóstico da paciente infértil. Neste artigo, pretende-se discutir informações atuais sobre o papel desse marcador para avaliação da reserva ovariana em candidatas a técnicas de reprodução assistida.
Measurement of anti-Müllerian hormone has been done in the practice of reproductive medicine for a more accurate prediction of ovarian follicular reserve, being an indirect marker of the quantity and quality of primordial follicles. A significant correlation with antral follicle count, the amount and maturity of oocytes in assisted reproductive techniques have been repeatedly evident in the literature, which is why we believe in the increasingly promising future of this hormone as a marker for the early assessment and prognosis of the infertile patient. In this article, we discuss current information on the role of the marker in the assessment of ovarian reserve in candidates for assisted reproduction techniques.
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Objective To discuss the uterus artery embolization of uterine flesh tumour clinical curative effect and influence of ovarian function.Methods Participants included 52 routine uterine artery embolization of uterine flesh tumour patients,all patients were followed up for one year,observed the curative effects of all subjects and the influence of the rightness of ovarian function.Results After treatment,the results showed that the curative effects,after 3 months,6 months,12 months compared with the preoperative,uterine tumor size,volume were significantly smaller,menstrual cycle extended,menstrual quantity increased,uterine fibroids oppression,anemia patients were significantly reduced,the difference was statistically significant (t =3.23,3.18,x2 =2.98,4.57,4.42,2.18,respectively,P ＜ 0.05) ; And after treatment with the extension of time,the symptoms and signs of patients were distinct improvement,the difference was statistically significant (t =2.66,2.57,x2 =3.45,5.12,6.54,3.67,respectively,P ＜ 0.05).After treatment of ovarian function results showed that the effects,after 3 months,6 months,12 months compared with the preoperative,serum levels of estradiol (E2),progesterone (P),follicle-stimulating hormone (FSH),corpus luteum erythropoietin (LH),prolactin (PRL) level had no change,there were no statistically significant differences (P ＞ 0.05).Conclusion Uterine artery embolization for treatment in patients with uterine fibroids has obvious curative effect,and the influence of ovarian function is not obvious.
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O hormônio anti-Mülleriano (HAM) é um marcador da reserva ovariana usado em técnicas de reprodução assistida com o objetivo de predizer a resposta inadequada à estimulação ovariana controlada. Também pode ser útil na predição de hiper-respostas em pacientes com síndrome dos ovários policísticos e colaborar para individualizar protocolos de estimulaçãomais adequados ao perfil de cada paciente e para o sucesso final do tratamento, muitas vezes dispendioso. Além do HAM existem outros marcadores da reserva ovariana, comocontagem de folículos antrais (CFA) e hormônio folículo estimulante (FSH), juntamente com o Estradiol (E2) e a Inibina B.
The Anti-Müllerian Hormone (AMH) is a marker of ovarian reserve used in assisted reproductive technologies, aiming at predict the response to controlled ovarian stimulation. Itmay also be useful for the prediction of hyperresponse to ovarian stimulation, as frequently observed in patients with Polycystic Ovary Syndrome. Being so, it is useful to individualize ovarian stimulation protocols, making the treatment more cost-effective. Besides AMH, there are other markers of ovarian reserve, as antral follicle count (AFC), Follicle Stimulating Hormone (FSH) along with Estradiol (E2) and inhibin B.
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Anti-Mullerian Hormone , Infertility, Female , Ovarian Function TestsABSTRACT
A avaliação do potencial reprodutivo de uma mulher traz grandes dificuldades na busca de um parâmetro fidedigno. Entre os testes disponíveis, incluem-se a biópsia ovariana, a ultrassonografia transvaginal, exames hormonais e testes com hormônios exógenos. Entretanto, nenhum deles demonstra resultados satisfatórios na investigação de pacientes inférteis. Mais recentemente, o Hormônio Antimülleriano tem sido considerado um marcador promissor dessa reserva. Esta revisão teve o objetivo de analisar cada um dos testes disponíveis, evidenciando vantagens e riscos potenciais, assim como sua real aplicabilidade na rotina ginecológica. Para isso, realizou-se uma revisão da literatura de 1998 até 2007, através do PubMed. Como resultado, observou-se que a dosagem de FSH, a contagem de folículos antrais e, principalmente, a dosagem de Hormônio Antimülleriano constituem os parâmetros mais promissores para esse objetivo. Novos estudos, entretanto, se fazem necessários para a melhor determinação desses resultados.
The assessment of a woman's reproductive potential brings difficulties in the search for a trusting parameter of this function. The tests available are ovarian biopsy, transvaginal pelvic ultrasound, hormonal parameters and tests using exogenous hormones. However, none of those shows satisfactory results for the investigation of infertile patients. Recently, Anti-Müllerian Hormone emerged as a promising marker of ovarian reserve. The objetive of this literature review is to analyse each one of the tests available, focusing in their potential advantages and risks, as well as its real applicability in gynecological practice. In order to accomplish that, articles from 1998 to 2007 were searched in PubMed. The results show that serum FSH, antral follicle count and mainly serum Anti-Müllerian Hormone are promising parameters for this aim. Other studies, however, are needed so this conclusion can be clarified.
Subject(s)
Female , Age Factors , Anti-Mullerian Hormone , Follicle Stimulating Hormone , Primary Ovarian Insufficiency/etiology , Ovarian Follicle/physiology , Ovarian Follicle , Infertility/etiology , Ovarian Function Tests , Ovary/physiologyABSTRACT
Objective To evaluate the influence of laparoscopic uterine artery ligation on ovarian function. Methods In this retrospective study ,46 patients with laparoscopic myomectomy were selected and randomly divided into Ligation group and Non-Ligation group. The serum concentrations of follicular stimulating hormone (FSH), luteinizing hormone ( LH), estrogen ( E_2) were measured be-fore treatment and 1 ,3 ,6,12 months after treatment. Ovulating functions of ovary were monitored. All results were compared between two groups. Results All patients ovulated after 6 months. There were no significant differences between two groups in the levels of FSH, LH and E_2,.before and after treatment(P>0.05). Conclusions Laparoscopic uterine artery ligation do not affect ovarian function of pa-tients with uterine leiomyoma.
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Objective To evaluate the impact of uterine artery embolization (UAE) tor uterine fibroids on ovarian function in young woman. Methods From 50 young patients with symptomatic leiomyomas managed with UAE, completed follow-up 24-36 months of clinical symptomatic, ovarian function continue and pregnancy outcome. All patients participants ranged in age from 24 to 40 years, divided into lower 35 years group (30 cases)and over 35 years group (20 cases). Results There was no significant difference in serum FSH, LH and E2 levels between two groups before UAE and 3-6, 12, 24-36 months after UAE(P > 0.05).The comparison of serum FSH, LH and E2 levels between two groups at the same time points before and after UAE were no significant difference (P> 0.05). Menstrual blood loss reduced and duration of flow shorted after UAE in two groups, the differences were significant (P < 0.05). Cycle interval in over 35 years group was longer in 3-6 months after UAE than that before UAE, the difference was significant (P <0.05). There were 2 patients occurred transient secondary amenorrhea after UAE in lower 35 years group, 3 patients occurred in over 35 years group. One patient had menopausal syndrome in 37 months after UAE, and serum FSH and LH levels were found to heighten obviously, 47% pregnancies and 30% deliveries in lower 35 years group, 45% pregnancies and 20% deliveries in over 35 years group. Conclusion Transient secondary amenorrhea would have been occurred in young patients with uterine fibroid performed UAE, no prematureo varian failure and premature menopause.
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8 oocytes) according to the number of oocytes collected in one ovary. On day of human chorionic gonadotrophin injection, PSV, EDV, PI, RI, S/D of ovarian stromal artery in the ovarian were detected and perifollicular vascularity were graded with color Doppler ultrasonography. Results Not only PSV and EDV of stromal artery but also perifollicular vascularity in low-response group was significantly lower than that of normal-response and high-response groups. PSV and EDV of ovarian stromal artery and perifollicular vascularity were highly interrelated with ovarian response. Conclusions The increase of PSV and EDV of ovarian stromal artery and perifollicular vascilarity indicate the improvement of perfusion in ovary and ovarian response.