Borges Edson, Braga Daniela P A F, Setti Amanda, Figueira Rita de Cássia, Iaconelli Assumpto
Fertility Medical Group, São Paulo, SP - Brazil.
Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Assistida, São Paulo, SP - Brazil.
JBRA Assist Reprod. 2017 Sep 1;21(3):176-182. doi: 10.5935/1518-0557.20170035.
This study aimed to identify a possible correlation between serum levels of anti-Müllerian hormone (AMH) and oocyte quality, embryo developmental competence, and implantation potential.
4488 oocytes obtained from 408 patients undergoing ICSI cycles were evaluated. Oocyte dimorphisms, embryo quality on days two and three, blastocyst formation competence, fertilization rates, implantation rates, and pregnancy rates were correlated with serum levels of AMH using Pearson's correlation coefficient and regression analysis.
A positive correlation was observed between serum levels of AMH and number of retrieved oocytes (CC: 0.600, p<0.001), fertilization rate (CC:0.595, p=0.048), and number of obtained embryos (CC:0.495, p<0.001). AMH did not affect the quality of cleavage stage embryos or the chance of blastocyst formation. However, AMH levels affected oocyte quality (OR:0.75, CI 0.44-0.96, p<0.001), and implantation (CC:0,116, p=0.031) and pregnancy (OR:1.22, CI:1.03-1.53, p<0.001) rates.
Serum levels of AMH are a useful predictor of ovarian response to COS, oocyte quality, and fertilization. However, AMH levels may also compromise clinical outcomes; lower AMH levels did not impair embryo development.
本研究旨在确定抗苗勒管激素（AMH）血清水平与卵母细胞质量、胚胎发育能力和着床潜能之间可能存在的相关性。
对408例接受卵胞浆内单精子注射（ICSI）周期治疗的患者获取的4488个卵母细胞进行评估。使用Pearson相关系数和回归分析，将卵母细胞二态性、第2天和第3天的胚胎质量、囊胚形成能力、受精率、着床率和妊娠率与AMH血清水平进行相关性分析。
观察到AMH血清水平与获卵数（相关系数：0.600，p<0.001）、受精率（相关系数：0.595，p=0.048）和获得的胚胎数（相关系数：0.495，p<0.001）呈正相关。AMH不影响卵裂期胚胎质量或囊胚形成几率。然而，AMH水平影响卵母细胞质量（比值比：0.75，可信区间0.44 - 0.96，p<0.001）、着床（相关系数：0.116，p=0.031）和妊娠率（比值比：1.22，可信区间：1.03 - 1.53，p<0.001）。
AMH血清水平是卵巢对控制性卵巢刺激（COS）反应、卵母细胞质量和受精的有用预测指标。然而，AMH水平也可能影响临床结局；较低的AMH水平并不损害胚胎发育。
