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抗苗勒管激素对体外受精-胚胎移植(IVF-ET)后胚胎质量、囊胚发育和妊娠率的预测价值。

The predictive value of anti-Mullerian hormone on embryo quality, blastocyst development, and pregnancy rate following in vitro fertilization-embryo transfer (IVF-ET).

机构信息

Reproductive Medcine Center, the First Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.

出版信息

J Assist Reprod Genet. 2013 Jun;30(5):649-55. doi: 10.1007/s10815-013-9973-5. Epub 2013 Mar 17.

Abstract

PURPOSE

The objective of this study was to investigate the predictive value of anti-Mullerian hormone (AMH) on fertilization rate (FR), blastocyst development, embryo quality, the outcome of the pregnancy and the live birth rate (LBR) following in vitro fertilization-embryo transfer (IVF-ET)/intracytoplasmic sperm injection (ICSI).

METHOD

In this prospective study outcomes were followed in 83 women undergoing cycles of IVF/ICSI within a university hospital. Basal serum AMH, follicle stimulating hormone (FSH), luteinizing hormone (LH) and antral follicle count (AFC) were measured on Day 3. Serum AMH (Gn6 AMH ) level was measured on Day 6 after the administration of gonadotrophin (Gn). AMH was measured in follicle fluid (FF AMH) on the day of ovum pick-up (dOPU). The numbers of retrieved and fertilized oocytes, good quality embryos and blastocysts were counted. Secondary outcome variables included clinical pregnancy rate (CPR) and LBR.

RESULTS

Spearman correlation analysis indicated that the numbers of oocytes, good quality embryos and blastocysts were associated with AMH (P < 0.05) and that LBR was correlated with FF AMH (r = 0.495, P < 0.05). No associations were found between FR and AMH (P > 0.05). Receiver operating characteristic analysis showed that the sensitivity of FF AMH at predicting CPR was 91.2%; the specificity was 86.5% and ROC(AUC) was 0.893 (P < 0.0001).

CONCLUSION

AMH parameters were correlated with good quality embryos and blastocysts, but only FF AMH showed a significant correlation with LBR and CPR.

摘要

目的

本研究旨在探讨抗苗勒管激素(AMH)对体外受精-胚胎移植(IVF-ET)/卵胞浆内单精子注射(ICSI)受精率(FR)、囊胚发育、胚胎质量、妊娠结局和活产率(LBR)的预测价值。

方法

本前瞻性研究纳入了在一所大学医院接受 IVF/ICSI 周期的 83 名女性。在第 3 天测量基础血清 AMH、卵泡刺激素(FSH)、黄体生成素(LH)和窦卵泡计数(AFC)。在给予促性腺激素(Gn)后第 6 天测量血清 AMH(Gn6 AMH)水平。在取卵日(dOPU)测量卵泡液(FF AMH)中的 AMH。计数获卵数、受精卵数、优质胚胎数和囊胚数。次要结局变量包括临床妊娠率(CPR)和 LBR。

结果

Spearman 相关分析表明,获卵数、优质胚胎数和囊胚数与 AMH 相关(P < 0.05),LBR 与 FF AMH 相关(r = 0.495,P < 0.05)。FR 与 AMH 之间无相关性(P > 0.05)。受试者工作特征曲线分析显示,FF AMH 预测 CPR 的灵敏度为 91.2%;特异性为 86.5%,ROC(AUC)为 0.893(P < 0.0001)。

结论

AMH 参数与优质胚胎和囊胚相关,但只有 FF AMH 与 LBR 和 CPR 有显著相关性。

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