Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
Reprod Biomed Online. 2010 Dec;21(6):757-61. doi: 10.1016/j.rbmo.2010.06.041. Epub 2010 Nov 1.
The conflicting results from studies on the predictive capabilities of serum anti-Müllerian hormone (AMH) for IVF pregnancy outcomes may be attributed to small sample sizes and disparities in the age of the study populations. The relationship between AMH and IVF pregnancy outcomes was clarified with retrospective cross-tabulation analyses (n=1558) stratified by age to control for its confounding effects. Serum AMH concentrations were divided into tertiles (≤ 0.29, 0.30-1.20, ≥ 1.21 ng/ml) and ages into four groups (<34, 34-37, 38-41, ≥ 42 years). For women <34, having serum AMH in the lowest tertile did not reduce the chance of IVF pregnancy/live birth compared with those with higher AMH concentrations. For women 34-41, a significant positive relationship existed between serum AMH and pregnancy rates. For women ≥ 42, serum AMH concentrations ≤ 0.29 ng/ml were associated with a 3% chance of pregnancy, and women with AMH ≥ 1.21 ng/ml had the same pregnancy rate as women with concentrations 0.30-1.20 ng/ml. In conclusion, AMH has limited predictive value for IVF outcomes in the two extremes of female reproductive age; however, for women between 34 and 41, higher serum AMH concentrations are associated with significantly greater chances of pregnancy (P<0.01).
血清抗苗勒管激素（AMH）对试管婴儿妊娠结局的预测能力的研究结果相互矛盾，这可能归因于样本量小以及研究人群年龄的差异。通过按年龄分层的回顾性交叉表分析（n=1558）来阐明 AMH 与试管婴儿妊娠结局的关系，以控制其混杂效应。将血清 AMH 浓度分为三分位数（≤0.29、0.30-1.20、≥1.21ng/ml），年龄分为四组（<34、34-37、38-41、≥42 岁）。对于<34 岁的女性，与高 AMH 浓度相比，血清 AMH 处于最低三分位并不会降低试管婴儿妊娠/活产的机会。对于 34-41 岁的女性，血清 AMH 与妊娠率之间存在显著的正相关关系。对于≥42 岁的女性，血清 AMH 浓度≤0.29ng/ml 与 3%的妊娠机会相关，而 AMH≥1.21ng/ml 的女性与浓度为 0.30-1.20ng/ml 的女性具有相同的妊娠率。总之，AMH 对女性生殖年龄两端的试管婴儿结局的预测价值有限；然而，对于 34 至 41 岁的女性，较高的血清 AMH 浓度与显著更高的妊娠机会相关（P<0.01）。
