关键词: 抗米勒管激素, 甲状腺自身免疫性疾病, 控制性超促排卵, 卵巢储备

Abstract:

Objective To evaluate the role of serum anti-Müllerian hormone（AMH） in infertile women with autoimmune thyroid disease（AITD） and its influence on the outcome of controlled ovulation hyper-stimulation（COH）. Methods A total of 245 infertile women who underwent in vitro fertilization（IVF） for the first time were classified into AITD positive group and AITD negative group. Thyroid stimulating hormone（TSH）,follicle stimulating hormone（FSH）,luteinizing hormone（LH）,estradiol（E2） and prolactin（PRL） and progesterone on the 3rd and 21st days of menstrual period were determined. According to the levels of AMH,the patients were classified into low-level and high-level AMH subgroups. Results Compared with AITD negative group,the level of AMH in AITD positive group was decreased（P<0.05）,and the level of FSH was increased in AITD positive group（P<0.05）. There was no statistical significance in age,body mass index（BMI）,TSH,E2,PRL,LH,progesterone,polycystic ovary syndrome and endometriosis between the 2 groups（P>0.05）. The dosage of recombinant follicle stimulating hormone（r-FSH）in AITD positive group was higher than that in AITD negative group（P<0.001）,the ratio of E2/r-FSH was lower（P<0.001）. There was no statistical significance in the numbers of MⅡ oocytes and primary embryo survival between AITD positive and negative groups（P>0.05）. The AMH level and E2/r-FSH ratio in AITD positive group were lower than those in AITD negative group（P<0.05）,the dosage of r-FSH was higher（P<0.05）,and there was no statistical significance for FSH,TSH and the number of primary embryo survival（P>0.05）. In the low AMH group,the number of MⅡoocytes in AITD positive group was lower than that in AITD negative group（P<0.001）. In the high AMH group,there was no statistical significance in the number of MⅡoocytes between AITD positive and negative groups（P>0.05）. Conclusions In infertile women,the low expression of AMH（low ovarian reserve） and AITD status have negative impacts on the outcome of COH. AITD should be accessed in which the ovarian reserve function is evaluated before COH.

Key words: Anti-Müllerian hormone, Autoimmune thyroid disease, Controlled ovulation hyper-stimulation, Ovarian reserve