抗苗勒管激素与男性生殖相关疾病的研究进展

抗苗勒管激素(anti-Mullerian hormone,AMH),又名苗勒管抑制素(Mullerian inhibiting substance,MIS),最早发现于男性胎儿,因抑制其苗勒管的发育而命名,对男性性分化具有重要作用。目前研究发现AMH在男性生殖相关领域有更加广泛的临床应用,主要体现在5个方面:(1)诊断两性畸形患者是否存在男性性腺,血清AMH比Y染色体敏感度更高,且是青春期评估睾丸功能较好的标志物;(2)与血清AMH水平比较,精浆AMH与睾丸生精功能显著相关,与精液质量呈正相关,是鉴别梗阻性、非梗阻性无精子症特异性较高的标志物;(3)精浆AMH是目前预测严重少、弱精子症患者精液冷冻-复苏率较好的指标;(4)精浆AMH水平可预测重组人卵泡刺激素(rh FSH)治疗特发性少、弱精子症的疗效;(5)对生育期需接受放化疗的男性肿瘤患者生育力的评估,精浆AMH是目前特异性最高的生物标志物。

Anti-Mullerian Hormone and Male Reproduction-related Diseases

Anti-Mullerian hormone (AMH), also known as Mullerian inhibiting hormone (MIS), was first discovered in the male fetus. AMH plays an important role in the male sexual differentiation by inhibiting Mullerian's development. Recent studies showed that AMH had more extensive application in male reproduction-related areas, mainly in the following five aspects: ① AMH can be used to diagnose whether those patients with hermaphroditism have male gonads, the sensitivity of serum AMH is higher than the Y chromosome. Meanwhile, AMH is a better markers in assessing the testicular function of adolescent. ② Compared with serum AMH, seminal AMH was significantly associated with spermatogenesis, and positively correlated with semen quality. Seminal AMH is specific marker to identify obstructive and non-obstructive azoospermia. ③ Seminal plasma AMH is a good index for predicting the recovery rate of the cryopreserved semen in asthenozoospermic men. ④Seminal AMH can be used to predict the outcome of recombinant human follicle-stimulating hormone treatment in men with idiopathic infertility. ⑤ Seminal AMH is one of the most specific biomarkers to assess male fertility of cancer patients after chemotherapy and radiotherapy.