Lamazou F, Genro V, Fuchs F, Grynberg M, Gallot V, Achour-Frydman N, Fanchin R, Frydman R
Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Antoine-Béclère, 157 rue de la Porte-de-Trivaux, Clamart, France.
J Gynecol Obstet Biol Reprod (Paris). 2011 May;40(3):205-10. doi: 10.1016/j.jgyn.2011.02.002. Epub 2011 Mar 22.
The objective is to compare the IVF procedures in modified natural cycle outcomes according to serum anti-Mullerian hormone (AMH) levels. We included in this retrospective study 342 patients undergoing their first IVF in modified natural cycle. Patients were regrouped in three groups according to their serum AMH level: group 1 was defined by patients with AMH level<0.97 ng/mL (<25th percentile), group 2, patients with AMH level between 0.97 ng/mL and 2.60 ng/mL (25-75th percentile), and group 3, patients with AMH level between 2.61 ng/mL and 6.99 ng/mL (>75th percentile). The main outcomes were cancellation rate, embryo transfer rate and clinical pregnancy rate, ongoing pregnancy rate and implantation rate. No difference has been observed on cancellation rate, embryo transfer rate, clinical pregnancy rate and implantation rate. The ongoing pregnancy rate per IVF cycle was respectively: 12.8±3.6% for AMH inferior to 0.97 ng/mL versus 12.5±2.5% for AMH between 0.97 to 2.60 ng/mL and 13.4±4.2% for AMH between 2.61 ng/mL and 6.99 ng/mL. In conclusion, IVF in modified natural cycles procedures should be considered as an option for patients with an altered ovarian reserve defined by a serum AMH inferior to 1 ng/mL. Serum AMH level seems a quantitative marker of the ovary but not a quality factor. Serum AMH level does not seem to be a prognostic factor for ongoing pregnancy rated in IVF modified cycles.
目的是根据血清抗苗勒管激素（AMH）水平比较改良自然周期中的体外受精（IVF）程序。我们纳入了342例在改良自然周期中首次接受IVF的患者进行这项回顾性研究。根据患者的血清AMH水平将其重新分为三组：第1组为AMH水平<0.97 ng/mL（<第25百分位数）的患者，第2组为AMH水平在0.97 ng/mL至2.60 ng/mL之间（第25 - 75百分位数）的患者，第3组为AMH水平在2.61 ng/mL至6.99 ng/mL之间（>第75百分位数）的患者。主要结局指标为取消率、胚胎移植率、临床妊娠率、持续妊娠率和着床率。在取消率、胚胎移植率、临床妊娠率和着床率方面未观察到差异。每个IVF周期的持续妊娠率分别为：AMH低于0.97 ng/mL的患者为12.8±3.6%，AMH在0.97至2.60 ng/mL之间的患者为12.5±2.5%，AMH在2.61 ng/mL至6.99 ng/mL之间的患者为13.4±4.2%。总之，对于血清AMH低于1 ng/mL定义的卵巢储备功能改变的患者，改良自然周期中的IVF程序应被视为一种选择。血清AMH水平似乎是卵巢的一个定量指标，但不是一个质量因素。血清AMH水平似乎不是IVF改良周期中持续妊娠率的预后因素。
