Abstract:
Objective To evaluate the value of female basic hormone and antimullerian hormone (AMH) levels combined with transvaginal three-dimensional ultrasound for the evaluation of ovarian reserve function.
Methods A total of 224 women admitted to Hainan Women and Children's Medical Center from June 2018 to June 2020 were selected and divided into two groups: decreased ovarian reserve function group (n=83) and normal ovarian reserve function group (n=141). Both groups underwent examination of female basic hormones [follicle stimulating hormone (FSH), FSH/luteinizing hormone (LH), and estradiol] and AMH as well as transvaginal three-dimensional ultrasound [ovarian volume, antral follicle count (AFC), and peak systolic blood flow velocity of ovarian stroma (PSV)]. The t test was used to compare the differences of FSH, FSH/LH, estradiol, AMH, ovarian volume, AFC, and PSV between the two groups. Receiver operator characteristic (ROC) curve was used to analyze the diagnostic value of female basic hormones, AMH, and transvaginal three-dimensional ultrasound in ovarian reserve function. The χ2 test was used to compare the sensitivity and specificity of female basic hormones, AMH, transvaginal three-dimensional ultrasound, and their combination in evaluating ovarian reserve function.
Results The levels of FSH, FSH/LH, and estradiol in the decreased ovarian reserve function group were significantly higher than those in the normal group [(11.65±7.08) U/L vs (7.12±3.44) U/L, t=6.424, P<0.001; (3.47±1.27) vs (1.81±0.68), t=12.737, P<0.001; (92.48±10.67) vs (64.73±7.95), t=22.163, P<0.001], while the level of AMH was signficantly lower than that in the normal group [(1.14±1.05) vs (3.36±1.82), t=10.156, P<0.001]. Ovarian volume, AFC, and PSV in the decreased ovarian function group were all significantly lower than those in the normal group [(3.09±2.13) cm3 vs (4.25±2.41) cm3, t=3.629, P<0.001; (4.62±3.78) vs (7.53±2.94), t=6.422, P<0.001; (10.27±4.16) cm/s vs (15.61±4.35) cm/s, t=9.017, P<0.001]. The areas under ROC curves (AUCs) of female basic hormones, AMH, and transvaginal three-dimensional ultrasound for evaluating decreased ovarian reserve function wrtr 0.749, 0.776, and 0.793 respectively, which were all lower than that (0.875) of the combined diagnosis of the three tests. The sensitivities of the three tests to evaluate ovarian reserve function were 72.66%, 72.69%, and 72.71%, respectively, which were all lower than that (87.93%) of the combined diagnosis (χ2=16.348, 22.457, and 16.392, P<0.001); the specificities were 67.21%, 68.69%, and 70.14%, respectively, which were all lower than that (73.72%) of the combined diagnosis (χ2=2.105, 1.317, and 0.707, P>0.05).
Conclusion Female basic hormones, AMH, and transvaginal three-dimensional ultrasound can be used to evaluate ovarian reserve function effectively. The combined diagnosis of the three tests have higher sensitivity and specificity than each of them.
Key words:
Ovarian reserve function,
Female basic hormones,
Anti mullerian hormone,
Transvaginal three-dimensional ultrasound
Changzhao Chen, tangna Wu, Yeliu Fu, Fangyan Lin. Female basic hormone and antimullerian hormone levels combined with transvaginal three-dimensional ultrasound for evaluation of ovarian reserve function[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2020, 17(12): 1208-1212.