Accuracy of the combined seven items of sex hormones and AMH test in the diagnosis of infertility and its clinical significance
Objective To explore the accuracy and clinical significance of the combined detection of seven sexual hormones and anti-Mullerian hormone(AMH)in the diagnosis of infertility.Methods A retrospective analysis of case data was conducted,and 2 050 infertile patients who received treatment in our hospital from January 2021 to January 2022 were selected as the study subjects and included in the infertility group.In the same period,1800 healthy women were selected as the healthy control group.The venous blood of the subjects in the two groups was collected from 2～4 days during the menstrual period.The levels of serum Luteinizing hormone(LH),prolactin(PRL),testosterone(T),progesterone(P),follicle-stimulating hormone(FSH),estradiol(E2),thyroid-stimulating hormone(TSH),and AMH were measured by the BECKMAN DXI-800 automatic chemiluminescence analyzer.The diagnostic value of seven items of sex hormones and AMH in infertility was evaluated using the receiver operating characteristic(ROC)curve.The infertility patients were followed up for 1 year,and divided into the successful pregnancy group(n=1 271)and failed pregnancy group(n=779)based on the results of assisted pregnancy treatment.The changes in sexual hormones and AMH levels between the two groups of patients were compared.Results There was no statistically significant difference in serum T,P,and E2 levels between the two groups(P＞0.05).The serum LH,TSH,FSH,and PRL levels in the infertile group were significantly higher than those in the healthy control group(P＜0.05).The serum AMH levels in the infertile group were significantly lower than those in the healthy control group(P＜0.05).The receiver operating characteristic showed that the area under the curve(AUC)of LH,TSH,FSH,PRL,AMH,and sex hormone indicators in the diagnosis of infertility were 0.768,0.778,0.745,0.671,0.715,and 0.816,respectively.The AUC for diagnosing infertility with sex hormone markers and AMH is 0.869.The proportion of patients with high LH,high TSH,high FSH,high PRL,and low AMH in the failed-to-conceive group was significantly higher than that in the successful-to-conceive group,and the proportion of surgery and hor-mone therapy was lower than those in the successful to conceive group(P＜0.05).Conclusion The serum LH,TSH,FSH,PRL,and AMH levels in infertile patients are significantly abnormally expressed,which has a certain value in the diagnosis of infertile patients,and the combined diagnostic value is the best.In addition,adjuvant hormone therapy to regulate changes in LH,TSH,FSH,PRL,and AMH levels during clinical surgical treatment can help improve the success rate of pregnancy and improve the prognosis of patients.
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