ObjectiveTo investigate the value of anti-Miillerian hormone(AMH) combined with follicle stimulating hormone(FSH) in the evaluation of ovarian reserve function in elderly women scheduled by assisted reproductive technology.
MethodsThe clinical data of 139 elderly patients(aged >35 years old) scheduled by assisted reproductive technology were retrospectively analyzed.According to the 2017 Poseidon poor ovarian response grouping criteria and ovarian reserve function test results, the patients were divided into normal group(n=51), diminished ovarian reserve(DOR) group(n=46) and premature ovarian failure(POF) group(n=42).According to the success of pregnancy within 1 year, the normal group was subdivided into the pregnant group(n=37) and non-pregnant group(n=14).The ovarian function-related assessment indexes were compared among all groups.The receiver operating characteristic curve(ROC) was used to evaluate the value of age, AMH and FSH alone or combined in the diagnosis of ovarian reserve dysfunction.
ResultsThe age, FSH and LH in DOR and POF groups were significantly higher than those in normal group, while the AMH, AFC and E2 were significantly lower than those in normal group(P < 0.01).The age, FSH and LH in POF group were higher than those in DOR group, and the AMH, AFC and E2 in POF group were lower than those in DOR group(P < 0.05 to P < 0.01).The differences of the levels of PRL and P among three groups were not statistically significant(P>0.05).The results of correlation analysis showed that the AMH was positively correlated with AFC and E2(P < 0.01), and negatively correlated with the age, FSH and LH(P < 0.01).The FSH was positively correlated with age and LH(P < 0.01 and P < 0.05), and negatively correlated with AFC and E2(P < 0.01).There was not significant correlation among AMH, FSH, PRL and P(P>0.05).The critical values of age, AMH and FSH in the diagnosis of ovarian reserve dysfunction were 36.25 years old, 1.27 ng/mL and 8.11 U/L, respectively.The AUC value, sensitivity, specificity, PPV and NPV of three combination detection in the diagnosis of ovarian reserve dysfunction were 0.932, 93.18%, 94.11%, 96.47%, 88.89% and 96.59%, respectively, which were higher than those of single detection(P < 0.05).The levels of AMH and E2 in pregnant group were significantly higher than those in non-pregnant group(P < 0.01 and P < 0.05), while the levels of FSH and LH in pregnant group were significantly lower than those in non-pregnant group(P < 0.01).
ConclusionsThe AMH and FSH are the effective indexes to evaluate the ovarian reserve function in elderly patients scheduled by assisted reproductive technology.The AMH combined with FSH detection technology can effectively replace the traditional evaluation system of ovarian reserve function.
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