AMH检测与女性卵巢功能储备医学课件

Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Dfdffdadafdf,Fdsfdds,Ffsdfsdf,fdadadf,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Dfdffdadafdf,Fdsfdds,Ffsdfsdf,fdadadf,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Dfdffdadafdf,Fdsfdds,Ffsdfsdf,fdadadf,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Dfdffdadafdf,Fdsfdds,Ffsdfsdf,fdadadf,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,Dfdffdadafdf,Fdsfdds,Ffsdfsdf,fdadadf,Title Imago Bold 26 pt.,Mastertextformat bearbeiten,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,0,AMH,检测与女性卵巢功能储备,专业资料，仅供医疗卫生专业人士参考,1,.,AMH检测与女性卵巢功能储备专业资料，仅供医疗卫生专业人士参,AMH,检测介绍,AMH,评估卵巢储备功能,小结,内容,专业资料，仅供医疗卫生专业人士参考,2,.,内容专业资料，仅供医疗卫生专业人士参考2.,抗苗勒氏管激素,（,Anti-Mllerian hormone，AMH）,又称：,苗勒氏管抑制因子,（,Mllerian,inhibiting factor，MIF）,苗勒氏管,抑制,素,（,Mllerian,inhibiting substance,MIS,）,具有使雄性胚胎中的,苗勒氏,管退化的作用,抗苗勒氏管,激素,:,龙雯晴,;,王伟民,;,喇端端,国外医学：妇产科学分册,2001,年 第,1,期,8,-10,专业资料，仅供医疗卫生专业人士参考,3,.,抗苗勒氏管激素（Anti-Mllerian hormone,出生 青春期,成年,AMH,分泌,时间：胚胎发育至第,7,周,时开始分泌，,出生后,4-12,月达到,高峰，,青春期后迅速减少。作用为抑制,苗勒氏,管,发育,为,输卵管、子宫和阴道,上段。,AMH,与男性,抗苗勒氏管,激素,:,龙雯晴,;,王伟民,;,喇端端,国外医学：妇产科学分册,2001,年 第,1,期,8-10,专业资料，仅供医疗卫生专业人士参考,4,.,出生 青春期,始基,卵泡,小窦前,卵泡,大窦前,卵泡,2-7mm,窦卵泡,8-12mm,窦卵泡,排卵前,卵泡,Anti-Mllerian,hormone,and ovarian dysfunction,Frank,J.Broekmans,Trends in Endocrinology and Metabolism,Vol19 No9,340-347 2008,达到,FSH,阈值选择,AMH,在小窦前卵泡、大窦前卵泡、,2-7mm,窦卵泡中表达,AMH,与女性,5,.,始基小窦前大窦前2-7mm8-12mm排卵前Anti-Ml,AMH,是评估卵巢功能和储备能力最有效和敏感的指标,2,1,Visser J et al.,a new marker for ovarian,function,Reproduction.2006;131:1-9,2,钱,警语 抗苗勒管激素与女性生育功能关系研究进展 生 殖 与 避 孕第,33,卷,7,期,Vol.33,No.7,473-478,3,AMH,and ovarian dysfunction Frank J.Broekmans,Trends in Endocrinology and Metabolism,Vol19,No9,340-347,2008,卵泡池的大小,在女,性出生时已经确立,1,卵巢储备,指卵巢内存留的卵泡数量和卵泡质量,2,AMH,检测卵巢储备的优势,AMH,在,小窦前卵泡、大窦前卵泡、,2-7mm,窦卵泡中,表达,3,专业资料，仅供医疗卫生专业人士参考,6,.,AMH是评估卵巢功能和储备能力最有效和敏感的指标2卵泡池的大,AMH,在女性生殖中的作用,抑制卵泡的募集：,AMH,在,人类卵泡发育,过程中发挥,重要作用,:,抑制原始卵泡募集,减少卵泡消耗,.,降低生长卵泡对,FSH,刺激的反应,AMH,与女性,钱警语 抗,苗勒管激素与女性生育功能关系研究,进展 生,殖 与 避 孕第,33,卷,7,期,Vol.33,No.7,473-478,AMH and ovarian dysfunction,Frank,J.Broekmans,Trends in Endocrinology and Metabolism,Vol19 No9,340-347 2008,专业资料，仅供医疗卫生专业人士参考,7,.,AMH在女性生殖中的作用抑制卵泡的募集：AMH与女性钱警语,AMH,出生 青春期成年,32,周后女性胎儿卵巢开始分泌,AMH;,出生,时，血清中,AMH,水平极低,;,18-25,岁,AMH,平均值最高，随着,年龄增长逐渐,下降,;,36,岁,后,AMH,水平显著下降,;,绝经期血清中不能被检测到,.,AMH,与女性,钱警语 抗,苗勒管激素与女性生育功能关系研究,进展 生,殖 与 避 孕第,33,卷,7,期,Vol.33,No.7 473-478,专业资料，仅供医疗卫生专业人士参考,8,.,AMH 出生,AMH,可在月经周期的任何一天检测,月经期,卵泡期,排卵期,黄体期,AMH(ng/mL),4.5,1.0,0.5,4.0,3.5,3.0,2.0,2.5,1.5,5.0,0.0,20,岁,2125,2630,3135,35,Kissell,et,al,Biological variability in serum,anti-Mu,llerian hormone throughout,the,menstrual,cycle in ovulatory,and,sporadic,anovulatory cycles,in,eumenorrheic,women,Human,Reproduction,Vol.29,No.8 pp.17641772,2014,AMH(ng/mL),月经期,卵泡期,黄体期,4.0,3.5,3.0,2.0,2.5,1.5,AMH,雌二醇,孕酮,排卵期,AMH,检测卵巢储备的优势,专业资料，仅供医疗卫生专业人士参考,9,.,AMH可在月经周期的任何一天检测月经期卵泡期排卵期黄体期AM,AMH,检测卵巢储备的优势,正常生育女性不同时间卵巢储备检测指标的比较,（,T1:Mean age 39.6,岁，,T2,：,Mean age,43.6,岁，,Mean time interval 4,年后随访，,n=81,）,(,Rooij,Serum antimllerian hormone levels best reflect,the,reproductive,decline with age in normal women,with,proven,fertility:a longitudinal,study,Fertil Steril 2005;83:97987.2005 by A