Merve DİZDAR, İbrahim KALE, İlgi ESEN, Rahime BAYIK

Serum anti-Mullerian hormon seviyesi ve antral follikül sayısının stimule edilmemiş menstruel siklustaki değişiminin saptanması

Amaç: Çalışmada düzenli menstruel siklusu olan sağlıklı hastalarda, doğal siklusta serum anti-Mullerian hormon değerlerinin ve antral follikül sayımının, intra-menstruel değişiminin saptanması amaçlanmıştır. Gereç ve Yöntemler: Çalışmaya menstruel siklusu düzenli olan, sistemik hastalık ve geçirilmiş over cerrahi öyküsü olmayan, son iki ay içinde hormonal kontraseptif preparat kullanmamış olan 50 sağlıklı kadın dahil edilmiştir. Serum anti-Mullerian hormon seviyeleri ve antral follikül sayısı stimüle edilmemiş aynı siklus içerisinde erken folliküler faz, geç folliküler faz ve luteal fazda olmak üzere üç kez değerlendirilmiştir. Yaş gruplarına göre serum anti-Mullerian hormon seviyelerinin karşılaştırılması amacıyla da hastalar genç (<35 yaş) ve ileri yaş (35 yaş) olmak üzere iki gruba ayrılmıştır. Bulgular: Hastaların yaş ortalaması 30.8, vücut kitle indeksi ortalaması 23.4 kg/m2 ve ortalama siklus uzunluğu 28.5 gün olarak bulunmuştur. Aynı menstruel siklusta erken folliküler faz, geç folliküler faz ve luteal faz olmak üzere üç kez değerlendirilen serum anti-Mullerian hormon seviyesi ortalaması 2.66 ng/dl ve ortalama antral follikül sayısı 17.4 olarak saptanmıştır. En yüksek serum anti-Mullerian hormon seviyesi ve antral follikül sayısı geç folliküler fazda bulunmuştur ve bu fark antral follikül sayısında olmasa da serum anti-Mullerian hormon seviyesi karşılaştırmasında istatistiksel olarak anlamlı bulunmuştur. (p=0.307, p= 0.044). Serum anti-Mullerian hormon variabilitesi genç grupta, ileri yaş gruba kıyasla daha fazla olarak saptanmış olup istatistiksel olarak anlamlı bulunmuştur. (0.241 vs 0.132, p=0.011) Sonuç: Serum anti-Mullerian hormon seviyeleri menstruel siklus içinde dalgalanmalar göstermekte olup, en yüksek serum anti-Mullerian hormon seviyesi geç folliküler fazda saptanmıştır. Antral follikül sayımı menstruel siklus boyunca sabit kalmıştır.

Anahtar Kelimeler:

Anti-Mullerian hormon, menstruel siklus, over rezervi, antral follikül sayısı, intra-siklik variabilite

Variability of serum anti-Mullerian hormone level and antral follicle count in an unstimulated menstrual cycle

Aim: To evaluate the variability of anti-Mullerian hormone (AMH) and antral follicle count (AFC) in an unstimulated menstrual cycle. Materials and Method: The study was designed on 50 women who had regular menstrual cycles and did not have any systemic disease or previous ovarian surgery. Serum AMH levels and antral follicle counts of all participants were evaluated three times in the same menstrual cycle in the early and late follicular phase and luteal phase. To evaluate the intracyclic AMH fluctuation according to age, participants were divided into two groups; younger (<35 years) and older (35 years old). Results: The mean age of the participants was 30.8, the mean BMI was 23.4 kg/m2, and the mean menstrual cycle duration was 28.5 days. Mean AMH values evaluated at three different times in the menstrual cycle, early follicular, late follicular, and luteal phase, were 2.66 ng/dl and mean AFC 17.4. The highest mean AMH level and AFC were detected in the late follicular phase and this was statistically significant for AMH level but not for AFC (p= 0.044, p=0.307, respectively). The intracyclic fluctuation of AMH was greater in the younger patient group. The coefficient of variation was 0.241 in the younger patient group, and 0.132 in the older patient group. (p=0.011) Conclusion: Serum AMH levels fluctuate throughout the menstrual cycle and the highest serum AMH level was detected in the late follicular phase. AFC remained stable throughout the cycle.

Keywords:

Anti-Mullerian hormone, menstrual cycle, ovarian reserve, antral follicle count, intra-cycle variability,

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