Ramezanali Fariba, Ashrafi Mahnaz, Hemat Mandana, Arabipoor Arezoo, Jalali Samaneh, Moini Ashraf
Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran; Obstetrics and Gynecology Department, Faculty of Medicine, Iran University of Medical Science, Tehran, Iran.
Reprod Biomed Online. 2016 May;32(5):503-12. doi: 10.1016/j.rbmo.2016.01.010. Epub 2016 Feb 2.
This cross-sectional study aimed to evaluate IVF/intracytoplasmic sperm injection (ICSI) outcomes in different polycystic ovary syndrome (PCOS) phenotypes (A, B, C and D) compared with a control group and the predictive values of serum anti-Müllerian hormone (AMH) in PCOS phenotypes for main outcomes. This study evaluated 386 PCOS women and 350 patients with male factor infertility. Women with phenotypes A and C had significantly higher concentrations of AMH than those with phenotype B (P < 0.001). Clinical pregnancy rate (CPR) in the phenotype D group (53.3%) was higher than other groups (32.5%, 26.4% and 36.8%, respectively, in phenotypes A, B and C), but not to a significant level. Multivariable regression analysis, after adjusting for women's age and body mass index, revealed that PCOS phenotypes A and B were associated with a decreased CPR compared with the control group (odds ratio [OR]: 0.46, confidence interval [CI]: 0.26-0.8, P = 0.007 and OR: 0.34, CI: 0.18-0.62, P = 0.001, respectively). It seems a combination of hyperandrogenism and chronic anovulation is associated with a negative impact on the CPR in these patients. These results demonstrated that AMH concentration is related to PCO morphology but not predictive for CPR and live birth rate.
这项横断面研究旨在评估不同多囊卵巢综合征(PCOS)表型(A、B、C和D)与对照组相比的体外受精/卵胞浆内单精子注射(ICSI)结局,以及血清抗苗勒管激素(AMH)在PCOS表型中对主要结局的预测价值。本研究评估了386例PCOS女性和350例男性因素不育患者。A表型和C表型女性的AMH浓度显著高于B表型女性(P<0.001)。D表型组的临床妊娠率(CPR)(53.3%)高于其他组(A、B和C表型组分别为32.5%、26.4%和36.8%),但差异无统计学意义。在对女性年龄和体重指数进行校正后的多变量回归分析显示,与对照组相比,PCOS表型A和B与CPR降低相关(优势比[OR]:0.46,置信区间[CI]:0.26-0.8,P=0.007;OR:0.34,CI:0.18-0.62,P=0.001)。雄激素过多和慢性无排卵的组合似乎会对这些患者的CPR产生负面影响。这些结果表明,AMH浓度与多囊卵巢形态有关,但对CPR和活产率无预测价值。