en هورمون های آنتی مولرین و آندروژن در ژن های با سندروم تخمدان پلی کیستیک تحت درمان با IVF/ICSI  Original Article Original Article <strong><span style="font-family:b mitra;">مقدمه: </span></strong><span style="font-family:b mitra;">علیرغم شیوع سندروم تخمدان پلی&shy;کیستسک (</span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">PCOS</span></span></span><span style="font-family:b mitra;">) هنوز یک تشخیص مشکل در اندوکرینولوژی، ژینوکولوژی و طب تولیدمثل است. جهت حل این مسئله کنفرانس روتردام پیشنهاد اضافه کردن تعداد فولیکول&shy;های یافت شده در سونوگرافی را به&shy;عنوان یک معیار جدید تشخیص داد که علاوه بر هیپراندروژنیزم و کاهش تخمک&shy;گذاری است. متأسفانه این موضوع نتوانست مقبولیت جهانی کسب کند.</span>_{<span style="font-family:b nazanin;"><span style="font-size:12.0pt;"></span></span>}<br> <strong><span style="font-family:b mitra;">هدف:</span></strong><span style="font-family:b mitra;"> هدف از انجام مطالعه بررسی نقش احتمالی تغییرات اندروژن&shy;ها و هورمون آنتی&shy;مولرین در بین زنان مبتلا به </span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">PCOS</span></span></span><span style="font-family:b mitra;"> در ارتباط با </span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">BMI</span></span></span><span style="font-family:b mitra;"> و نتایج بعد از </span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">IVF</span></span></span><span style="font-family:b mitra;"> بود. </span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;"></span></span><br> <strong><span style="font-family:b mitra;">مواد و روش&shy;ها: </span></strong><span style="font-family:b mitra;">در این مطالعه اولیه گذشته&shy;نگر 195 زن با </span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">PCOS</span></span></span><span style="font-family:b mitra;"> شرکت کردند که بر اساس </span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">BMI</span></span></span> <span style="font-family:b mitra;">به گروه&shy;های چاق با </span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">kg/m²</span></span></span><span style="font-family:b mitra;"> 27></span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">BMI</span></span></span>&nbsp;(نفر<span style="font-family:b mitra;">91) و وزن بیش از حد با </span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">kg/m²</span></span></span><span style="font-family:b mitra;"> 27</span><span style="font-family:times new roman,serif;">&le;</span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">BMI&nbsp;</span></span></span><span style="font-family:b mitra;">&nbsp; </span><span dir="RTL"><span style="font-family:b mitra;"><span style="font-size:11.0pt;">(104 نفر)&nbsp;</span></span></span><span style="font-family:b mitra;">&nbsp; تقسیم شدند. میزان سرمی اندروژن&shy;ها (</span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">DHEAS</span></span></span><span style="font-family:b mitra;">، تستوسترون و </span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">A4</span></span></span><span style="font-family:b mitra;">) و هورمون آنتی&shy;مولرین (</span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">AMH</span></span></span><span style="font-family:b mitra;">) با پروفیل اندوکرین ونتایج سیکل&shy;ها اندازه&shy;گیری و مقایسه شد.</span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;"></span></span><br> <strong><span style="font-family:b mitra;">نتایج:</span></strong> <span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">AMH</span></span></span><span style="font-family:b mitra;">، </span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">A4</span></span></span><span style="font-family:b mitra;">، </span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">FSH</span></span></span><span style="font-family:b mitra;"> و </span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">TSH</span></span></span><span style="font-family:b mitra;"> به طور معنی&shy;دار در زنان چاق بیشتر از زنان با وزن بیش از حد بود (0/001></span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">p</span></span></span><span style="font-family:b mitra;">). بر عکس نسبت </span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">LH:FSH</span></span></span><span style="font-family:b mitra;">، </span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">E₂</span></span></span><span style="font-family:b mitra;">، </span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">PRL</span></span></span><span style="font-family:b mitra;"> و </span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">DAHES</span></span></span><span style="font-family:b mitra;"> به طور معنی&shy;دار در زنان چاق کمتر از زنان با وزن بیش از حد بود (0/0001></span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">p</span></span></span><span style="font-family:b mitra;">). میزان اووسیت&shy;های به&shy;دست آمده، بالغ و بارور شده به طور معنی&shy;داری در زنان چاق بیشتر از زنان با وزن بیش از حد بود. در بین زنان چاق حامله </span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">AMH</span></span></span><span style="font-family:b mitra;"> و </span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">A4</span></span></span><span style="font-family:b mitra;"> به طور معنی&shy;دار افزایش داشت و </span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">DAHES</span></span></span><span style="font-family:b mitra;"> به طور معنی&shy;داری در مقایسه با زنان با وزن بیش ازحد کاهش یافته بود. </span><br> <strong><span style="font-family:b mitra;">نتیجه&shy;گیری:</span></strong><span style="font-family:b mitra;"> زنان چاق با </span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">PCOS</span></span></span><span style="font-family:b mitra;"> در مقایسه با زنان که در گروه با وزن بیش از حد قرار داشتند شانس بیشتری برای حاملگی داشتند. به&shy;علاوه اندروژن&shy;ها و میزان </span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">AMH</span></span></span><span style="font-family:b mitra;"> پیشنهاد می&shy;شود که در </span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">IVF</span></span></span><span style="font-family:b mitra;"> در زنان چاق و با وزن بیش از حد در نظر گرفته شود.</span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;"></span></span> <strong>Background:</strong> Despite its frequency, the polycystic ovary syndrome (PCOS) is still a difficult diagnosis in endocrinology, gynecology, and reproductive medicine. The Rotterdam consensus conference proposed to include the ultrasonographic follicle count as a new diagnostic criterion. Unfortunately, its assessment does not offer sufficient reliability worldwide.<br> <strong>Objective: </strong>To explore the possible roles of altered circulating androgens and anti-mullerian hormone among PCOS women regarding their body mass index and their outcomes after IVF.<br> <strong>Materials and Methods:</strong> In this cross sectional study, 195 women with PCO were included, they were divided according to their body mass index (BMI <27 kg/m2) as obese PCOS (n=91) and overweight PCOS (BMI &ge;27 kg/m2) (n=104). Serum levels of androgens (dehydroepiandrosterone sulfate [DHEAS], testosterone and androstenedione [A4]), and anti-mullerian hormone (AMH) were assessed and compared with the endocrine profile and cycles outcomes.<br> <strong>Results: </strong>AMH, A4, FSH, and TSH concentrations were significantly higher in obese than in overweight women (p˂0.001). Contrary, LH: FSH ratio values, E2, PRL and DAHE-S levels were significantly lower in obese than in overweight women (p˂0.0001). Total oocyte retrieved, mature and fertilized oocyte were significantly higher in obese than in overweight women. Among pregnant obese PCOS women both AMH and A4 were significantly increased and DAHE-S was significantly decreased compared to pregnant overweight PCOS women.<br> <strong>Conclusion:</strong> Obese PCOS women have a higher chance of getting pregnant over those categorized as overweight PCOS. Also, androgens and AMH levels recommended to be considered in IVF attributes among obese and overweight PCOS women. سندروم تخمدان پلی کیستیک, هورمون اندروژن, هورمون آنتی مولرین, آندرواستندیون. Polycystic ovary syndrome, Androgen hormone, Anti-mullerian hormone, Androstenedione. 883 0 http://ijrm.ir/browse.php?a_code=A-10-1-547&slc_lang=en&sid=1 Menha Swellam No Department of Biochemistry, Genetic Engineering and Biotechnology Research Division, National Research Center, Dokki, Giza, Egypt Abeer Khaial No Department of Biochemistry, Genetic Engineering and Biotechnology Research Division, National Research Center, Dokki, Giza, Egypt Tamer Mosa dr_tamermosa@hotmail.com Yes Department of Biochemistry, Genetic Engineering and Biotechnology Research Division, National Research Center, Dokki, Giza, Egypt Hatim El-Baz No Department of Biochemistry, Genetic Engineering and Biotechnology Research Division, National Research Center, Dokki, Giza, Egypt Mohamed Said No Department of Obstetrics and Gynecology, Ain-Shams University, Cairo, Egypt