Impactul hormonului anti - Müllerian la pacientele cu polichistoză ovariană supuse drillingului ovarian laparascopic

Abstract

AMH has been involved in the pathogenesis of PCOS. The goal of this research was to measure AMH before and after laparascopic ovarian drilling and to evaluate its prognosis regarding ovulatory respons, to investigate AMH changes and other hormonal disturbunces after LOD, to explore the effects of LOD further. This prospective study included anovulatory women with PCOS undergoing LOD (n= 40). Plasma AMH concentrations were measured before and 5 days after surgical treatment. The pretreatment plasma AMH concentrations were 6,2 (1,0-21,0) ng/ml in women having LOD treatment. Women who ovulated after LOD (n= 34) had a significantly lower preoperative AMH 5.9 ( 1.0 – 7,7) ng/ml compared with the nonresponders 9,6 (8,2 – 21,0) ng/ml. Using receiver-operating characteristic curve analysis, AMH was found to be a useful predictor of no ovulation after LOD with area under the curve of 0.804 (P=0.025). Using a cut-off of 7.7 ng/ml, AMH had a sensitivity of 78% and a specificity of 76% in the prediction of no ovulation after LOD. For all patients, plasma AMH7.7 ng/ml was associated with a reduced chance of ovulation after treatment (P=0.004). Following LOD, the median AMH concentration significantly (P=0.003) decreased to 4,6 (0,7- 5,4) ng/ml.

АМH a fost implicat în patogeneza sindromului ovarelor polichistice. Scopul acestui studiu a fost de apreciere a AMH seric înainte şi după drilling ovarian laparascopic şi de evaluare a unui prognostic ovulator, de a investiga АМH şi alte schimbări hormonale după drilling ovarian laparascopic. Acest studiu propectiv a inclus pacientele anovulatorii cu acest sindrom, care au suferit drilling ovarian laparascopic (n= 40). Concentrațiile plasmatice ale AMH seric au fost măsurate înainte şi 5 zile după tratament chirurgical. Concentrațiile serice preoperatorii ale AMH au fost de 6,2 (1,0-21,0) ng/ml. Pacientele care au ovulat după drilling ovarian laparascopic (n= 34) au avut un AMH relativ mic 5.9 ( 1.0 - 7,7) ng/ml, comparativ cu cele care nu auovulat 9,6 (8,2 - 21,0) ng/ml.Aşadar AMH s-a dovedit a fi un predictor important al pacientelor care nu vor raspunde nici la drilling ovarian laparascopic. Prin criteriul 7.7 ng/ml, АМH a avut o sensibilitate de 78% şi o specificitate de 76% în prognosticul pacientelor care nu vor ovula după tratamentul chirurgical. Pentru toţi pacienţii, plasma AMH7.7 ng/ml, a fost asociat cu o probabilitate mai mică de ovulatie dupa tratament.După drillingul ovarian laparascopic concentrația AMH seric semnificativ a scăzut la 4,6 (0,7 - 5,4) ng/ml.