抗苗勒管激素的妇科临床应用新进展_王肖.pdf

· · 国际妇产科学杂志2016 年8 月第43 卷第4 期 J Int Obstet Gynecol ，August 2016 ，Vol. 43 ，No. 4 458 ·综 述· 抗苗勒管激素的妇科临床应用新进展 王肖， △ 卢媛 【摘 要】 抗苗勒管激素（anti-Müllerian hormone ，AMH）可调节生殖细胞生长和分化。AMH 是评估卵巢储备的理 想标志物，对预测女性绝经年龄、指导生育力保护具有重要的临床价值；是预测控制性超促排卵结局的良好指标，有助 于识别辅助生殖技术（ART）中卵巢反应异常的女性；可作为卵巢颗粒细胞瘤的可靠随访指标，也可能用于上皮性卵巢 癌、宫颈癌和子宫内膜癌的辅助治疗；AMH 不仅与多囊卵巢综合征（PCOS）患者的不孕、胰岛素抵抗等临床症状有关， 也能帮助不孕症患者制定促排卵治疗方案及其他治疗策略；还有助于辨别不同的性分化发育异常。综述AMH 对卵泡 生长发育的调节作用及AMH 的相关影响因素，从卵巢功能、卵巢反应性、妇科肿瘤、PCOS、性分化发育异常5 个方面重 点阐述AMH 的妇科临床应用。 【关键词】 抗苗勒管激素；卵泡；卵巢；生殖器肿瘤，女（雌）性；多囊卵巢综合征；危险因素 The New Gynecological Clinical Application of Anti-Müllerian Hormone WANG Xiao, LU Yuan. Obstetrics and Gynecology Hospital Affiliated to Fudan University, Shanghai 200090, China Corresponding author: LU Yuan, E-mail: pipiluyuan@163.com 【Abstract 】 Anti-Müllerian hormone （AMH ） can regulate the growth and differentiation of germ cells. AMH is an ideal marker to evaluate the ovarian reserve, which is of great clinical significance for predicting the female menopause age and indicating fertility preservation. It retains its high predictive value for controlled ovarian hyperstimulation, and helps to identify women who are easy to be ovarian stimulation abnormalities in assisted reproductive technology （ ） ； t also can act as a ART I reliable follow -up marker of the ovarian granular cell tumor and used as an adjuvant therapy for epithelial ovarian cancer, ； cervical cancer and endometrial carcinoma and may be correlated with infertility, insulin resistance and other clinical manifestations of polycystic ovarian syndrome （PCOS ） and be useful to establish treatment protocols and to define the best