The Application Of Anti-Mullerian Hormone In IVF-ET Of Patients With Polycystic Ovary Syndrome

Objective: To explore the predictive value of Anti-Müllerian hormone(AMH)and follicular output rate(FORT)in in vitro fertilization-embryo transfer(IVF-ET)of patients with policystic ovarian syndrome.Methods : A total of 90 patients with PCOS and 60 patients with fallopian tube factors who received IVF-ET treatment were selected during June 2015 to December 2016 in the reproductive medicine center of Guilin medical university.Enzyme-linked immunoassay(ELISA)was applied to detect the AMH value.The AMH value and laboratory index were compared between the two groups.To calculate FORT value by the number of 16-22 mm follicle(PFC)in HCG day and 3-8mm basal antral follicular after pituitary drop.The FORT value were divided into low group(< 42%),middle group(42%-58%)and high group(> 58%).The differences of clinical date were compared.Results: The total of Gn in PCOS group was significantly higher than that of control group.There was no significant difference in normal fertilization rate,quality embryo rate and clinical pregnancy rate between the two groups.There was no significant difference in AMH level between the pregant group and non-pregnant group in PCOS group.The normal fertilization rate,quality embryo rate and clinicalpregnancy rate in moderate FORT of PCOS group were significant higher than the other two groups.The normal fertilization rate,quality embryo rate and clinical pregnancy rate in high FORT of non-PCOS group were significant higher than the other two groups.The AMH value in the high FORT group was significantly lower than that of the other two groups.Conclusions:(1)AMH can reduce the reactivity of follicle to exogenous Gn,and the total Gn dose increases with the AMH increase in PCOS patients.Due to PCOS patients with ovarian hyperresponsiveness,easily lead to the occurrence of OHSS,so clinical application should be properly controlled Gn start dose,in order to avoid the occurrence of OHSS.(2)AMH value can predict ovarian response during COH but can not predict the clinical outcome in PCOS patients.(3)FORT can effectively assess the reactivity of ovaries to exogenous Gn in PCOS patients with COH,and PCOS patients with moderate FORT can achieve a better clinical outcome.(4)FORT was negatively correlated with AMH levels,and the combination of both could better guide the clinical treatment of PCOS patients.