Evaluation of ovarian reserve function in women preparing for a second child by anti-Müllerian hormone and MMP/TIMP in serum and cervical mucus combined with transvaginal ultrasound
Objective To investigate the value of anti-Müllerian hormone(AMH)in serum and cervical mucus,matrix metalloproteinases(MMPs)/tisszle inhibitor of metalloproteinase(TIMPs)combined with transvaginal ultrasound in evaluating ovarian reserve function in women preparing for a second child.Methods A total of 76 women who underwent pre-pregnancy examination and second pregnancy preparation in the Dongguan Shijie Hospital from November 2021 to September 2022 were included in the study.All the subjects underwent transvaginal ultrasound examination,and they were divided into normal group(n=32,normal ovarian function,antral follicle count≥5)and low group(n=44,ovarian hypofunction,antral follicle count<5)according to the number of sinus follicles.The transvaginal ultrasound parameters,AMH in serum and cervical mucus,and MMPs/TIMPs were compared between the two groups.Pearson linear correlation was used to analyze the relationships between ultrasound parameters,AMH in serum and cervical mucus,MMPs/TIMPs and antral follicle count.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficacies of transvaginal ultrasound parameters,AMH in serum and cervical mucus,MMP/TIMP alone and their combination for ovarian hypofunction.Results The endometrial thickness and ovarian volume of the low group were(3.83±1.17)mm and(5.59±1.34)cm³,respectively,which were lower than those of the normal group([4.54±1.52]mm,[7.62±2.41]cm³,both P<0.05).Serum AMH level in the low group was lower than that in the normal group([2.11±0.65]ng/ml vs[4.65±3.78]ng/ml,P<0.05).There was no significant difference in the cervical mucus AMH between the two groups(both[0.08±0.02]ng/ml,P>0.05).The MMPs/TIMPs in serum and cervical mucus of the low group were 1.19±0.65 and 1.34±0.32,which were higher than those of the normal group(1.07±0.09 and 1.10±0.27,both P<0.05).Pearson correlation analysis showed that antral follicle count was positively correlated with endometrial thickness,ovarian volume and serum AMH level,and was negatively correlated with MMPs/TIMPs in serum and cervical mucus(all P<0.05).ROC curve analysis showed that the area under the curve of the combination of transvaginal ultrasound parameters,serum AMH,serum and cervical mucus MMPs/TIMPs in the diagnosis of ovarian dysfunction was 0.869,which was higher than that of each index alone(all P<0.05).Conclusion The combined application of serum AMH,serum and cervical mucus MMPs/TIMPs and transvaginal ultrasound is of great value in the evaluation of ovarian reserve function in women preparing for a second child.
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