رابطه هورمون آنتی‌مولرین با پاسخ تخمدانی و پیامد باروری در زنان نابارور تحت درمان با ART و IUI

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دانشیار گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی کردستان، سنندج، ایران.

2 استادیار گروه آمار و اپیدمیولوژی، دانشکده پزشکی، دانشگاه علوم پزشکی کردستان، سنندج، ایران.

3 رزیدنت گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی کردستان، سنندج، ایران.

چکیده

مقدمه: هورمون آنتی­ مولرین، ارتباط خوبی با سن زن، تعداد فولیکول‌های آنترال و نتیجه روش‌های کمک باروری دارد. مطالعه حاضر با هدف بررسی رابطه سطح هورمون ضدمولرین با پاسخ تخمدانی و پیامدهای بارداری در زنان نابارور تحت درمان با ART و IUI انجام شد.
روش‌کار: این مطالعه به روش مقطعی (توصیفی - تحلیلی) در سال‌های 1400-1395 بر روی 186 زن نابارور تحت درمان با روش درمان نازایی ART مراجعه کننده به مرکز نازایی بیمارستان بعثت سنندج انجام شد. اطلاعات دموگرافیک، سطح FSH و AMH، تعداد آمپول گونادوتروپین تزریق شده، تعداد فولیکول آنترال و تعداد جنین به‌دست آمده بررسی و در پرسشنامه ثبت شد. همچنین پیامدهای بارداری شامل سقط، مرگ جنینی، ناهنجاری جنینی و تولد تعیین و در پرسشنامه ثبت شد. تجزیه و تحلیل داده­ها با استفاده از نرم‌افزار آماری SPSS (نسخه 22) و آزمون‌های کای دو، تست دقیق فیشر، آنالیز واریانس یک‌طرفه و همبستگی پیرسون انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته­ ها: میانگین هورمون آنتی­ مولرین 0/3±0/4 با دامنه 12-1/0 نانوگرم بر میلی‌لیتر و میانگین هورمون FSH 5/2±1/6 با دامنه 7/12-6/0 واحد در میلی‌لیتر بود. بین سطح هورمون آنتی­ مولرین با تعداد HMG تزریق شده، تعداد تخمک بازیابی شده، تعداد جنین کل، جنین نوع A و B در زنان با IVF آگونیست ارتباط معنی­ داری وجود داشت (05/0>p). بین سطح هورمون آنتی ­مولرین با سقط، مرگ جنینی، تولد زنده و ناهنجاری نوزاد ارتباط معنی ­داری وجود نداشت (05/0<p).
نتیجه ­گیری: تعیین سطوح AMH در تجویز گنادوتروپین، پیش‌بینی تعداد فولیکول آنترال، تخمک بازیابی شده و تعداد جنین به‌دست آمده کمک کننده است، اما سطح هورمون آنتی­ مولرین با پیامدهای باروری ارتباط ندارد.

کلیدواژه‌ها

عنوان مقاله [English]

The relationship between anti-mullerian hormone and ovarian response and fertility outcome in infertile women undergoing assisted reproductive techniques (ART) and IUI

نویسندگان [English]

  • Fariba Seyedoshohadaei 1
  • Masomeh Rezaie 1
  • Khaled Rhmani 2
  • Fariba Bakhshi 3
1 Associate Professor, Department of Obstetrics & Gynecology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
2 Assistant Professor, Department of Statistics and Epidemiology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
3 Resident, Department of Obstetrics & Gynecology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
چکیده [English]

Introduction: Anti-Mullerian Hormone (AMH) is related to woman's age, the number of antral follicles, and the outcome of assisted reproductive techniques. The present study was performed with aim to evaluate the relationship between anti-mullerian hormone levels and ovarian response and pregnancy outcomes in infertile women undergoing assisted reproductive techniques (ART) and IUI.
Methods: This cross-sectional (descriptive-analytical) study was performed on 186 infertile women undergoing ART referred to Besat Hospital Infertility Center, Sanandaj, Iran during 2016-2020. Demographic information, FSH level, AMH level, number of gonadotropin injections, number of antral follicles and number of fetuses were evaluated and recorded in the questionnaire.. Also, pregnancy outcomes including abortion, fetal death, fetal malformation and birth were determined and recorded in the questionnaire. Data were analyzed by SPSS software (version 22) and chi-square, Fisher exact, one-way analysis of variance and Pearson correlation. P<0.05 was considered statistically significant.
Results: The mean of anti-mullerian hormone level was 4.0±3.0 (range of 0.1 to 12 ng / ml) and the mean of FSH level was 6.1±2.5 (range of 0.6 to 12.7 IUI / L). There was a significant relationship between anti-mullerian hormone level with the number of ovarian follicles, number of injected HMG, number of eggs retrieved, total number of embryos (P <0.05). There was no significant relationship between anti-mullerian hormone levels with abortion, fetal death, live birth and neonatal malformations (P >0.05).
Conclusion: Determination of AMH levels can help for administration of gonadotropins, prediction of antral follicle numbers, number of eggs retrieved and number of embryos obtained, but Anti-mullerian hormone levels are not associated with pregnancy outcomes.

کلیدواژه‌ها [English]

  • Anti-mullerian hormone
  • Agonist
  • Gonadotropin
  • IVF
  • Pregnancy outcome

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مجله زنان، مامایی و نازایی ایران
دوره 26، شماره 1
فروردین 1402
صفحه 10-19

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