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Klinični pomen določanja Anti-Müllerjevega hormona v postopkih umetne oploditve : magistrski študij laboratorijske biomedicine
Domajnko, Valerija (Author), Ostanek, Barbara (Mentor) More about this mentor... This link opens in a new window, Osredkar, Joško (Co-mentor)

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Abstract
Neplodnost je vedno večji problem sodobnega sveta. Ker je vse več parov, ki vstopi v postopek umetne oploditve, je to področje zelo zanimivo za iskanje novih načinov ugotavljanja, spremljanja in zdravljenja neplodnosti. Trije najpogostejši vzroki neplodnosti pri ženskah so endometrioza, sindrom policističnih jajčnikov in neprehodnost jajcevodov. Ženske, ki se odločijo za umetno oploditev, so podvržene številnim diagnostičnim testom, med katerimi je v vedno večji meri tudi meritev koncentracije Anti-Müllerjevega hormona (AMH) v serumu. AMH nastaja v jajčniku in uravnava razvoj primarnih foliklov v jajčniku. Je odličen označevalec ovarijske rezerve. Zmanjšana vrednost AMH v biološkem vzorcu kaže na manjšo količino in slabšo kakovost jajčnih foliklov. Na kakovost jajčnih foliklov pa vpliva tudi prisotnost oksidativnega stresa. Količino antioksidantov v biološkem vzorcu določimo z meritvijo celokupnega antioksidativnega stresa (TAS). Namen našega dela je bil ugotoviti povezavo med koncentracijo AMH v folikularni tekočini (FT – AMH) in koncentracijo AMH v serumu (S – AMH) v treh skupinah pacientk z različnimi diagnozami neplodnosti. Prav tako je naš namen ugotoviti povezavo med TAS v folikularni tekočini (FT – TAS) in koncentracijo FT - AMH. V študiji so sodelovale pacientke, ki so prvič vstopile v postopek umetne oploditve (in vitro fertilizacija). Vzorci folikularne tekočine so se zbrali v postopku punkcije jajčnikov, istočasno jim je bila odvzeta tudi kri za določanje AMH in TAS v serumu. Pacientke smo razdelili v tri skupine: skupina s tuboperitonealnim vzrokom neplodnosti (kontrolna skupina) je obsegala 40 pacientk, skupina z endometriozo (70 pacientk) in skupina s sindromom policističnih jajčnikov (37 pacientk). V vzorcih seruma in folikularne tekočine smo določali AMH po principu ELISA. Prav tako smo v vzorcih folikularne tekočine določili vrednost TAS s kolorimetrično metodo. Pri primerjavi S – AMH in FT – AMH v vseh treh skupinah smo prišli do rezultata, da se koncentracije S – AMH in FT – AMH med seboj v posameznih skupinah statistično ne razlikujejo, iz česar lahko sklepamo, da vrednost S – AMH odraža vrednost FT – AMH. Pri primerjavi vseh treh skupin med sabo smo ugotovili, da pri meritvah S – AMH ne obstaja signifikantna razlika med skupinama pacientk s tuboperitonealnim vzrokom neplodnosti in med endometriozo. Tudi med skupino pacientk z tuboperitonealnim vzrokom in sindromom policističnih jajčnikov ni signifikantne razlike pri meritvah FT – AMH. Prav tako smo prišli do zaključka, da prisotnost TAS v folikularni tekočini ne vpliva na koncentracijo FT – AMH in da obstaja signifikantna razlika pri koncentracijah FT – TAS med vsemi tremi skupinami pacientk. Na osnovi naših ugotovitev lahko zaključimo, da za merjenje koncentracije AMH lahko uporabimo serumski vzorec kot tudi vzorec folikularne tekočine. Prav tako lahko zaključimo, da so koncentracije AMH niso različne v vseh treh preiskovanih skupinah pacientk in da prisotnost TAS v folikularni tekočini nima vpliva na koncentracijo AMH v folikularni tekočini.

Language:Slovenian
Keywords:umetna oploditev folikularna tekočina in vitro fertilizacija Anti-Müllerjev hormon koncentracije hormona neplodnost
Work type:Master's thesis/paper (mb22)
Tipology:2.09 - Master's Thesis
Organization:FFA - Faculty of Pharmacy
Year:2017
Publisher:[V. Domajnko]
Number of pages:VI, 51 f.
UDC:618.177-089.888.11+616.697(043.3)
COBISS.SI-ID:4335729 Link is opened in a new window
Views:350
Downloads:199
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Secondary language

Language:English
Title:Clinical use of Anti-Müllerian hormon in in vitro fertilization procedures
Abstract:
Infertility is a growing problem of modern world. Endometriosis, polycystic ovary syndrome and tubal abnormalities are most common gynaecological disorders that lead in female infertility. Because of more and more couples needing in vitro fertilization (IVF), this problem is very interesting for research (diagnosis, monitoring and treatment of infertility).IVF requires many diagnostic tests. One of them is the measurement of the concentration of Anti-Müllerian hormone (AMH) in serum. AMH is produced in ovary and regulates development of primary follicles, therefore it is an excellent marker of ovarian reserve. Decreased concentration of AMH in a biological sample, reflects lower quantity and quality of ovarian follicles. Quality of ovarian follicles can also be assessed by measurement of total antioxidative status (TAS). The purpose of our work was to investigate the association between concentration of AMH in the follicular fluid and serum in three groups of female patients with various diagnoses of infertility. We also studied the association between the TAS and concentration of AMH in follicular fluid. Female patients with first time IVF were included in this study. From these women we collected follicular fluid in the process of ovum biopsy. At the same time we also collected blood for determination AMH and TAS. The patients were divided into three groups: group with tubal abnormalities (control) (40 patients), group with endometriosis (70 patients) and group with polycystic ovarian syndrome (37 patients). We determined concentration of AMH in serum and follicular fluid with ELISA principle and concentration of TAS in follicular fluid with colorimetric method. We found that concentration of AMH in serum (S – AMH) and AMH in follicular fluid (FT – AMH) are not statistically different within each of the groups. The value of S - AMH reflects the value of FT - AMH. On the other hand we found no significant difference between S - AMH between group with tubal abnormalities and group with endometriosis. We also found no significant difference between FT - AMH between group with tubal abnormalities and group with polycystic ovarian syndrome. Furthermore, level of TAS in follicular fluid (FT – TAS) does not affect concentration of FT – AMH. There is a significant difference between concentrations of FT – TAS in all three groups. Based on these results, we can conclude that serum and follicular fluid can be used for measurement of concentration of AMH. It also can be concluded that concentrations of AMH are not different between all three groups of female patients. The presence of FT - TAS also has no effect on concentration of FT - AMH.


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