Somigliana Edgardo, Lattuada Debora, Colciaghi Barbara, Filippi Francesca, La Vecchia Irene, Tirelli Amedea, Baffero Giulia M, Paffoni Alessio, Persico Nicola, Bolis Giorgio, Fedele Luigi
Department of Obstetrics and Gynecology, "Fondazione IRCCS Ca' Granda" Hospital, Milan, Italy.
University of Milan, Milan, Italy.
Acta Obstet Gynecol Scand. 2015 Dec;94(12):1307-12. doi: 10.1111/aogs.12761. Epub 2015 Sep 16.
The correlation between ovarian reserve and infertility remains unclear. Albeit poorly predictive of pregnancy success in in vitro fertilization cycles, serum anti-Müllerian hormone (AMH) has been acknowledged as a surrogate measure of ovarian reserve and is commonly evaluated in women seeking pregnancy. Disentangling whether low serum AMH affects natural fecundity is clinically important, as this information helps physicians in providing appropriate counseling to women and may impact on management strategies.
This was a nested case-control study from a prospective cohort of pregnant women undergoing first trimester screening for aneuploidies. Cases were subfertile women having tried to become pregnant for 12-24 months. Controls were subsequent age-matched fertile women. Inclusion criteria for both cases and controls were: (i) age > 18 years, (ii) natural conception, (iii) regular menstrual cycles (24-35 days). We used quantitative detection of serum AMH and interviews with the women. The main outcome measure was the proportion of women with serum AMH < 1.1 ng/mL.
Seventy-six subfertile women and 76 matched fertile controls were selected. In the two study groups, there were 11 (15%) and 15 (20%) women with serum AMH < 1.1 ng/mL, respectively (p = 0.52). The crude odds ratio for subfertility in women with low serum AMH was 0.69 [95% confidence interval (CI) 0.29-1.62]. The adjusted odds ratio was 0.85 (95% CI 0.35-2.10). The median (interquartile range) serum concentration of AMH in subfertile and control women was 2.6 (range 1.6-4.0) and 2.8 (range 1.4-4.3) ng/mL, respectively (p = 0.91).
Low serum AMH is not associated with female subfertility.
卵巢储备与不孕症之间的相关性仍不明确。尽管血清抗苗勒管激素（AMH）对体外受精周期的妊娠成功率预测性较差，但它已被公认为卵巢储备的替代指标，并且在寻求怀孕的女性中普遍进行评估。弄清楚低血清AMH是否会影响自然生育能力在临床上很重要，因为这些信息有助于医生为女性提供适当的咨询，并可能影响管理策略。
这是一项嵌套病例对照研究，来自一个接受孕早期非整倍体筛查的孕妇前瞻性队列。病例为试图怀孕12至24个月的亚生育女性。对照为随后年龄匹配的可育女性。病例和对照的纳入标准为：（i）年龄>18岁，（ii）自然受孕，（iii）月经周期规律（24 - 35天）。我们采用血清AMH的定量检测并对女性进行访谈。主要结局指标是血清AMH<1.1 ng/mL的女性比例。
选取了76名亚生育女性和76名匹配的可育对照。在两个研究组中，分别有11名（15%）和15名（20%）女性血清AMH<1.1 ng/mL（p = 0.52）。血清AMH低的女性亚生育的粗比值比为0.69 [95%置信区间（CI）0.29 - 1.62]。调整后的比值比为0.85（95%CI 0.35 - 2.10）。亚生育女性和对照女性的AMH血清浓度中位数（四分位间距）分别为2.6（范围1.6 - 4.0）和2.8（范围1.4 - 4.3）ng/mL（p = 0.91）。
低血清AMH与女性亚生育无关。
