Açıklanamayan İnfertilitesi Olan Hastalarda Serum Antimüllerian Hormon Seviyeleri ile Tedavi Cevabı ve Fertilite Sonuçları İlişkisi

Öz

Amaç: Açıklanamayan infertilite nedeniyle Klomifen Sitrat ile Ovulasyon İndüksiyonu ve İntrauterin İnseminasyon CC+IUI yapılan hastalarda serum Antimüllerian Hormon AMH değerleri ile tedavi sonuçları arasındaki ilişkiyi değerlendirmeyi amaçladık.Gereç ve Yöntemler: Açıklanamayan infertilite nedeniyle CC+ IUI tedavisi yapılan 60 hastanın sonuçları retrospektif olarak değerlendirildi. AMH değeri 3,15 ng/mL olan hastaların ve ß hCG değeri pozitif ya da negatif olan hastaların klinik ve laboratuvar özellikleri karşılaştırıldı. AMH seviyeleri ile başarılı ovaryan yanıt, gebelik testi pozitifliği, ovulasyon tetikleme günü serum Östradiol E2 düzeyi ve midluteal serum progesteron düzeyi arasındaki ilişkiyi değerlendirdik.Bulgular: Hastaların ortalama yaşı 30.5±4.7 yaş idi. Receiver Operating Characteristics ROC Analizinde, gebeliğin saptanması için AMH eşik değeri %53 sensitivite ve %34 spesifite ile 3.15 ng/mL olarak saptandı. AMH değeri >3,15 ng/mL olan ve

Anahtar Kelimeler

• Açıklanamayan infertilite, Antimüllerian Hormon, Gebelik öngörüsü, Klomifen sitrat, Ovulasyon indüksiyonu

The Relationship between Serum Antimullerian Hormone Levels and Treatment Response and Fertility Results in Patients with Unexplained Infertility

Abstract

Objective: We aimed to evaluate the relationship between serum Antimullerian Hormone AMH levels and treatment results in patients who underwent ovulation induction and intrauterine insemination CC + IUI with clomiphene citrate due to unexplained infertility.Material and Methods: The results of 60 patients who underwent CC + IUI treatment due to unexplained infertility were retrospectively evaluated. The clinical and laboratory characteristics of patients with positive or negative ß hCG values and patients with AMH 3.15 ng/mL levels were compared. We evaluated the association of AMH levels with a successful ovarian response, positive pregnancy test, ovulation triggering day serum estradiol E2 levels and mid-luteal serum progesterone levels.Results: The mean age of the patients was 30.5 ± 4.7 years. In the Receiver Operating Characteristics ROC analysis, the cut off value of AMH on detection of pregnancy was found 3.15 ng/mL with 53% sensitivity and 34% specificity. When we compared the patients with AMH levels 3.15 ng/mL, the mean age, duration of infertility, Body Mass Index BMI , Luteinizing Hormone LH , Thyroid Stimulating Hormone TSH , ovulation triggering day E2, mid-luteal progesterone levels, and ß hCG positivity were not significantly different between the two groups. In multiple logistic regression analysis, there was a significant relationship between mid-luteal progesterone levels and positive pregnancy test but there was no relationship between AMH and a positive pregnancy test.Conclusion: AMH is not a good marker of predicting pregnancy in patients with unexplained infertility treated with CC + IUI

Keywords

• Unexplained infertility, Antimullerian Hormone, Pregnancy prediction, Clomiphene citrate, Ovulation induction

Kaynakça

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