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女性年龄、血清抗苗勒管激素水平和卵母细胞数量会影响体外受精/卵胞浆内单精子注射周期中整倍体囊胚的形成率和数量。

Female age, serum antimüllerian hormone level, and number of oocytes affect the rate and number of euploid blastocysts in in vitro fertilization/intracytoplasmic sperm injection cycles.

作者信息

La Marca Antonio, Minasi Maria Giulia, Sighinolfi Giovanna, Greco Pierfrancesco, Argento Cindy, Grisendi Valentina, Fiorentino Francesco, Greco Ermanno

机构信息

Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy; Clinica Eugin, Modena, Italy.

Center For Reproductive Medicine, European Hospital, Rome, Italy.

出版信息

Fertil Steril. 2017 Nov;108(5):777-783.e2. doi: 10.1016/j.fertnstert.2017.08.029. Epub 2017 Oct 4.

Abstract

OBJECTIVE

To study the relative role of female age and ovarian reserve, measured through serum antimüllerian hormone (AMH) in determining the rate and number of euploid blastocysts in in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles.

DESIGN

Retrospective analysis of cycles performed in 2014-2015.

SETTING

Tertiary referral IVF center.

PATIENT(S): A total of 578 infertile couples undergoing IVF/ICSI and preimplantation genetic screening (PGS) analysis.

INTERVENTIONS(S): All embryos were cultured and biopsied at the blastocyst stage. The method involved whole-genome amplification followed by array comparative genome hybridization. Serum AMH was measured by means of the modified Beckman Coulter AMH Gen II assay.

MAIN OUTCOME MEASURES

The rate and number of euploid blastocysts and their correlation with ovarian reserve and response to stimulation.

RESULT(S): The mean (±SD) age of patients was 37.6 ± 4.1 years, and the mean number of blastocysts per patient was 3.1 ± 2. The total number of blastocysts available to the analysis was 1,814, and 36% of them were euploid after PGS. Age and serum AMH were significantly and independently related to the rate of euploid blastocysts available for patients. As an effect of the cohort size, the number of mature oocytes positively affected the total number of euploid blastocysts per patient.

CONCLUSION(S): A strong positive age-independent relationship between AMH level and the rate of euploid blastocysts was found. This confirms that the measurement of ovarian reserve by means of AMH has high relevance when counseling infertile patients.

摘要

目的

研究女性年龄和通过血清抗苗勒管激素(AMH)测定的卵巢储备在体外受精(IVF)/卵胞浆内单精子注射(ICSI)周期中对整倍体囊胚率和数量的相对作用。

设计

对2014 - 2015年进行的周期进行回顾性分析。

地点

三级转诊体外受精中心。

患者

共578对接受IVF/ICSI和植入前基因筛查(PGS)分析的不孕夫妇。

干预措施

所有胚胎均在囊胚阶段进行培养和活检。该方法包括全基因组扩增,随后进行阵列比较基因组杂交。血清AMH通过改良的贝克曼库尔特AMH Gen II测定法进行测量。

主要观察指标

整倍体囊胚的率和数量及其与卵巢储备和刺激反应的相关性。

结果

患者的平均(±标准差)年龄为37.6±4.1岁,每位患者的平均囊胚数为3.1±2个。可供分析的囊胚总数为1814个,其中36%在PGS后为整倍体。年龄和血清AMH与患者可获得的整倍体囊胚率显著且独立相关。由于队列规模的影响,成熟卵母细胞的数量对每位患者的整倍体囊胚总数有积极影响。

结论

发现AMH水平与整倍体囊胚率之间存在与年龄无关的强正相关关系。这证实了在为不孕患者提供咨询时,通过AMH测量卵巢储备具有高度相关性。

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