Department of Obstetrics and Gynecology, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
Hum Reprod. 2011 Jul;26(7):1905-9. doi: 10.1093/humrep/der134. Epub 2011 Apr 30.
To determine whether women with extremely low-serum anti-Mullerian hormone (AMH) levels (<0.1-0.4 ng/ml) still demonstrate live birth potential with assisted reproduction and whether such potential is age dependent.
Between January 2006 and October 2009, 128 consecutive infertility patients with AMH ≤0.4 ng/ml were retrospectively evaluated for pregnancy chances and live birth rates after IVF.
Patients presented at a mean (±SD) age of 40.8 ± 4.1 years, with mean (±SD) baseline FSH of 15.7 ± 11.1 mIU/ml and mean (±SD) AMH of 0.2 ± 0.1 ng/ml. One hundred and twenty-eight women underwent a total of 254 IVF cycles. Twenty clinical pregnancies were recorded (7.9% per cycle start [95% confidence interval (CI): 4.9-11.9%]; 15.6% cumulative [CI: 9.8-23.1%]). These pregnancies resulted in 13 live births in 12 women (i.e. 11 singletons and a pair of twins) and 8 patients miscarried. Eight deliveries occurred after the first cycle (6.3% per cycle start) and four after subsequent IVF cycles (3.2%). When evaluated according to female age, 70 women ≤42 years presented with 16 clinical pregnancies that resulted in 10 deliveries (14.3%), while 58 patients >42 years presented with four clinical pregnancies that resulted in 2 deliveries (3.4%), representing a reduced pregnancy chance (P = 0.013) and delivery rate (P = 0.036) versus age ≤42 years.
With extremely low-serum AMH levels, moderate, but reasonable pregnancy and live birth rates are still possible. Extremely low AMH levels do not seem to represent an appropriate marker for withholding fertility treatment.
为了确定血清抗苗勒管激素（AMH）水平极低（<0.1-0.4ng/ml）的女性是否仍然具有通过辅助生殖获得活产的能力，以及这种能力是否与年龄有关。
2006 年 1 月至 2009 年 10 月，对 128 例 AMH≤0.4ng/ml 的连续不孕患者进行回顾性评估，以确定其接受体外受精（IVF）后的妊娠机会和活产率。
患者的平均（±SD）年龄为 40.8±4.1 岁，平均（±SD）基础卵泡刺激素（FSH）为 15.7±11.1mIU/ml，平均（±SD）AMH 为 0.2±0.1ng/ml。128 名妇女共进行了 254 个 IVF 周期。记录了 20 例临床妊娠（每周期开始的 7.9%[95%置信区间（CI）：4.9-11.9%]；累计 15.6%[CI：9.8-23.1%]）。这些妊娠导致 12 名妇女中的 13 名活产（即 11 名单胎和 1 对双胞胎）和 8 名流产。8 例分娩发生在第一个周期（每周期开始的 6.3%），4 例发生在随后的 IVF 周期（3.2%）。按女性年龄评估时，≤42 岁的 70 名妇女有 16 例临床妊娠，其中 10 例分娩（14.3%），而>42 岁的 58 名妇女有 4 例临床妊娠，其中 2 例分娩（3.4%），这表明妊娠机会（P=0.013）和分娩率（P=0.036）均降低。
在血清 AMH 水平极低的情况下，仍然可以获得适度但合理的妊娠和活产率。极低的 AMH 水平似乎不能作为拒绝进行生育治疗的合适标志物。
