International Journal of Reproductive BioMedicine
International Journal of Reproductive BioMedicine
IJRM
Medical Sciences
http://ijrm.ir
1
admin
2476-4108
2476-3772
10.29252/ijrm
en
jalali
1401
12
1
gregorian
2023
3
1
21
3
online
1
fulltext
en
تعیین سطح سرمی آنتی مولرین هورمون در زنان با پیش آگهی پایین تحت درمان لقاح آزمایشگاهی/تزریق داخل سیتوپلاسمی اسپرم: یک مطالعه کوهورت
Determination of serum anti-Mullerian hormone levels in a low-prognosis women treated in-vitro fertilization/intracytoplasmic sperm injection: A cohort study
Assisted Reproductive Technologies
Original Article
Original Article
<div style="text-align: justify;"><span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مقدمه: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">پیشبینی نتیجه درمان افراد تحت درمان با لقاح آزمایشگاهی یا تزریق داخل سیتوپلاسمی اسپرم (</span></span><span dir="LTR" style="font-size:10.0pt">IVF/ICSI</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) با استفاده از غلظت هورمون آنتی­مولرین (</span></span><span dir="LTR" style="font-size:10.0pt">AMH</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) به طور گسترده</span></span><span dir="LTR" style="font-size:11.0pt"><span arial="" style="font-family:">­</span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">ای مورد استفاده قرار گرفته است. با توجه به راهبردهای بیمار محور که شامل تعریف تعداد تخمک فردی (</span></span><span dir="LTR" style="font-size:10.0pt">POSEIDON</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) است، پاسخ­دهندگان ضعیف یا </span></span><span dir="LTR" style="font-size:10.0pt">poor</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">معیار بولونیا به افراد با پیش­آگهی پایین تغییر کرده­اند. این معیار پیش آگهی پایین را به 4 گروه تقسیم می­کند.</span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">هدف: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">هدف از این مطالعه بررسی سطح </span></span><span dir="LTR" style="font-size:10.0pt">AMH</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">خون در گروه زنان تحت درمان با </span></span><span dir="LTR" style="font-size:10.0pt">IVF/ICSI</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">بود که به نظر می­رسید که پیشآگهی پایینی داشته باشند.</span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مواد و روش ­ها: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">یک مطالعه کوهورت گذشتهنگر بین 252 شرکتکننده مشکوک به قرار گرفتن در گروه با پیش آگهی پایین از ژانویه 2016 تا دسامبر 2019 در </span></span><span dir="LTR" style="font-size:10.0pt">Morula IVF</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">، بیمارستان ملی، سورابایا، اندونزی انجام شد. سطوح سرمی </span></span><span dir="LTR" style="font-size:10.0pt">AMH</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">و میزان بارداری مشاهده شده در بین 4 زیر گروه مقایسه شد.</span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نتایج: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مقدار </span></span><span dir="LTR" style="font-size:10.0pt">cutoff AMH</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">با حساسیت 7/86% و اختصاصیت 70%، </span></span><span dir="LTR" style="font-size:10.0pt">ng/ml</span><span style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> 7/1 برای تشخیص زنان با پیش­آگهی پایین با استفاده از معیارهای </span></span><span dir="LTR" style="font-size:10.0pt">POSEIDON</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">بود. تفاوتی در میزان بارداری بین تمام گروه­ها وجود نداشت (05/0 </span></span><span lang="FA" style="font-size:10.0pt"><</span> <span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">).</span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نتیجه گیری:</span></span></b> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">سطوح </span></span><span dir="LTR" style="font-size:10.0pt">AMH</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مطابق با دستورالعملهای </span></span><span dir="LTR" style="font-size:10.0pt">POSEIDON</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> ممکن است نشاندهنده پیش آگهی ضعیف برای زنانی که </span></span><span dir="LTR" style="font-size:10.0pt">IVF/ICSI</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> دارند، باشد. برای پیشبینی پیشآگهی بد در زنان، مقدار </span></span><span dir="LTR" style="font-size:10.0pt">cutoff</span><span style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> باید مشخص شود.</span></span></span></span></span></span></span></div>
<div style="text-align: justify;"><span style="font-family:Times New Roman;"><span style="font-size:12pt"><b>Background: </b>Outcome prediction of participants treated with in-vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI) using anti-Mullerian hormone (AMH) concentration has been widely used. According to the patient-oriented strategies encompassing individualized oocyte number (POSEIDON) definition, low prognosis Bologna responders have changed from poor. This definition divides low prognosis into 4 groups.</span><br>
<span style="font-size:12pt"><b>Objective:</b> The purpose of this study was to assess blood AMH levels in the group of women treated with IVF/ICSI who were thought to have a low prognosis.</span><br>
<span style="font-size:12pt"><b>Materials and Methods: </b>A retrospective cohort study among 252 suspected low-prognosis group participants was assessed between January 2016 and December 2019 at Morula IVF, National hospital, Surabaya, Indonesia. Observed AMH serum levels and pregnancy rates were compared among 4 subgroups.</span><br>
<span style="font-size:12pt"><b>Results: </b>The AMH cutoff value was 1.7 ng/mL with a sensitivity of 86.7 percent and a specificity of 70% for diagnosing low-prognosis women using POSEIDON criteria. There was no difference in the pregnancy rate between those groups (p > 0.05).</span><br>
<span style="font-size:12pt"><b>Conclusion:</b> AMH levels may indicate a poor prognosis for women having IVF/ICSI in accordance with POSEIDON guidelines. To predict the poor prognosis in women, the cutoff value must be identified.</span></span><span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span serif="" style="font-family:Cambria,"><span style="font-size:10.0pt"><span style="font-family:"Times New Roman","serif""></span></span></span></span></span></div>
<span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="font-family:Cambria,serif"><span lang="EN-US" style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"></span></span></span></span></span>
پیش آگهی, تکنیکهای کمک باروری, هورمون غدد جنسی, لقاح آزمایشگاهی, سلامت باروری.
Prognosis, Assisted reproductive technics, Gonadal hormone, Fertilization in vitro, Reproductive health.
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http://ijrm.ir/browse.php?a_code=A-10-2072-1&slc_lang=en&sid=1
Ferdy Royland
Marpaung
ferdyoke@gmail.com