| BackgroundOvarian reserve function is an important indicator of women’s fertility.The diseases caused by its abnormality include polycystic ovary syndrome(PCOS),decreased ovarian reserve function(DOR)and premature ovarian failure(POF).With the full opening of two and three children,women’s fertility has attracted much attention.Abnormal ovarian reserve function causes infertility,which seriously affects the normal life of women of childbearing age.In 2018,the number of female infertility cases reached 477000.The traditional hormones to predict ovarian reserve function include follicle stimulating hormone(FSH),estradiol(E2),inhibin B(INH-B),luteinizing hormone(LH),testosterone(T)and antral follicle counting(AFC)under B-ultrasound.However,these indexes are often affected by patients’ menstrual cycle or pelvic environment,and anti Mullerian hormone(AMH)is more sensitive to early ovarian follicle monitoring,and can reflect ovarian reserve function earlier,more conveniently and more effectively.However,the relationship between AMH and other endocrine hormones in infertile patients and the diagnostic efficacy of different diseases have not been comprehensively analyzed.ObjectiveTo analyze the value of AMH in the diagnosis of ovarian reserve function diseases such as PCOS,DOR and POF,so as to evaluate the ovarian reserve function of female individuals as soon as possible and accurately,and guide the clinical early diagnosis of infertility.Method1.Study subjects: 264 women who visited the gynecology and obstetrics infertility center of Sanmenxia Hospital of the Yellow River from October 2018 to October 2020 were selected.The subjects were divided into 4 groups: PCOS group,82 cases;DOR group,89 cases;POF group,52 cases;the control group was 41 women with normal ovarian reserve function.2.Sample collection and detection methods: female individuals who have not yet amenorrhea collect blood in the early morning of the second to fourth day of menstrual cycle.Those who have amenorrhea collect blood in the early morning of the day of treatment.After centrifugation at 3500r/min for 10 min,take supernatant,and detect AMH,FSH,E2,LH and T in serum by chemiluminescence method.To observe the difference of hormone expression between different subjects,analyze the correlation between AMH and FSH,E2,LH and T.The sensitivity and specificity in the auxiliary diagnosis of different ovarian reserve function diseases.3.Statistical processing: SPSS22.0 software was used.When all measurement indicators conform to normal distribution,they were measured by mean±standard deviation(x±s).One way ANOVA was used for the comparison between multiple groups of data,T-test was used to compare the mean of two groups,and ROC curve was used for diagnostic efficacy analysis.The difference was statistically significant(P<0.05).Result1.Comparison of hormone levels between different groups:(1)comparison with the control group: in PCOS group,the levels of AMH,T,E2 and LH increased,while the level of FSH decreased.In DOR group,the levels of AMH decreased and the levels of FSH and LH increased,but there was no significant change in E2 and T.In POF group,the levels of AMH and E2 decreased,while the levels of FSH,T and LH increased.(2)Comparison between disease groups: Through the comparison between DOR group and POF group,it was found that the expression levels of FSH,T and LH decreased,while the expression levels of AMH and E2 increased in DOR group.2.Correlation between AMH and basic endocrine hormones: AMH was medium strength positively correlated of with T and E2(r=0.582,0.629,P<0.05),and negatively correlated with FSH and LH(r=-0.598,-0.140,P<0.05).3.Efficacy evaluation of auxiliary diagnosis of ovarian reserve function diseases:when assisting in the diagnosis of different ovarian reserve function diseases,it is found that AMH is better than other basic endocrine hormones.(1)In the auxiliary diagnosis of PCOS: the AUC of AMH was 0.851,the sensitivity was 70.3%,and the specificity was91.0%.(2)In the auxiliary diagnosis of DOR: the AUC of AMH was 0.891,the sensitivity was 80.3%,and the specificity was 93.2%.(3)In the auxiliary diagnosis of POF: the AUC of AMH was 0.906,the sensitivity was 79.2%,and the specificity was 94.5%.ConclusionAMH is superior to FSH,LH,T,E2 in the auxiliary diagnosis of PCOS,POF,DOR and other diseases with abnormal ovarian reserve function.AMH can be used for the prediction and evaluation of abnormal ovarian reserve function. |
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