Li Y, Tan J Q, Mai Z Y, Yang D Z
Center for Reproductive Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.
Zhonghua Fu Chan Ke Za Zhi. 2018 Jan 25;53(1):23-30. doi: 10.3760/cma.j.issn.0529-567X.2018.01.006.
Explore the value of anti-Müllerian hormone (AMH) in predicting pregnant outcomes of polycystic ovary syndrome (PCOS) patients undergone assisted reproductive technology. The study totally recruited 1 697 patients who underwent the first in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) cycle in Sun Yat-sen Memorial Hospital from the January 2014 to December 2015. The patients were divided into two groups based on the age<35 (758) and ≥35 years old (939) , compare the basic data and pregnant outcomes of controlled ovarian hyerstimulation. Spearman correlation method was conducted to analyze the relations between AMH and clinical outcomes. The logistic regression method and partial correlation analysis were used to judge the main factors which determine pregnancy outcomes by controlled the confounding factors. The receiver operating characteristic curve (ROC) was used to evaluate the predictive sensitivity and specificity of AMH. In the group of PCOS patient younger than 35 years, AMH were correlated with the number of antral follicles (0.388) and retrieved oocytes (0.235) . When the effect of total dosage and starting dosage of gonadotropin were controlled, AMH was still significantly associated with the number of retrieved oocytes (0.05) . AMH had no predictive value for the clinical pregnancy of PCOS patient younger than 35 years (area under ROC curve=0.481, 0.768) . In the group of PCOS patient≥35 years old, AMH were correlated with the number of antral follicles (0.450) , retrieved oocytes (0.399) , available embryo (0.336) and high quality embryo (0.235) . When the effect of total dosage and starting dosage of gonadotropin were controlled, the correlations were still significant between those indexes (all 0.05) . AMH had no predictive value for the clinical pregnancy of PCOS patient ≥35 years old (area under ROC curve=0.535, 0.560) . However, the clinical pregnancy rate of the group of PCOS patient ≥35 years old was slightly higher than the control group (0.062) . AMH has no predictive value for the pregnancy outcome of PCOS patient. The pregnancy rate of PCOS patient ≥35 years old is slightly higher than the younger group, because the PCOS patient may have better ovarian reserve.
探讨抗苗勒管激素（AMH）在预测接受辅助生殖技术的多囊卵巢综合征（PCOS）患者妊娠结局中的价值。该研究共纳入了2014年1月至2015年12月在中山大学附属孙逸仙纪念医院接受首次体外受精（IVF）或卵胞浆内单精子注射（ICSI）周期的1697例患者。根据年龄将患者分为两组，年龄<35岁（758例）和≥35岁（939例），比较控制性卵巢刺激的基础数据和妊娠结局。采用Spearman相关方法分析AMH与临床结局之间的关系。采用逻辑回归方法和偏相关分析，通过控制混杂因素来判断决定妊娠结局的主要因素。采用受试者工作特征曲线（ROC）评估AMH的预测敏感性和特异性。在年龄小于35岁的PCOS患者组中，AMH与窦卵泡数（0.388）和获卵数（0.235）相关。当控制促性腺激素的总剂量和起始剂量的影响时，AMH仍与获卵数显著相关（P<0.05）。AMH对年龄小于35岁的PCOS患者的临床妊娠无预测价值（ROC曲线下面积=0.481，P>0.768）。在年龄≥35岁的PCOS患者组中，AMH与窦卵泡数（0.450）、获卵数（0.399）、可用胚胎数（0.336）和优质胚胎数（0.235）相关。当控制促性腺激素的总剂量和起始剂量的影响时，这些指标之间的相关性仍然显著（均P<0.05）。AMH对年龄≥35岁的PCOS患者的临床妊娠无预测价值（ROC曲线下面积=0.535，P>0.560）。然而，年龄≥35岁的PCOS患者组的临床妊娠率略高于对照组（P<0.062）。AMH对PCOS患者的妊娠结局无预测价值。年龄≥35岁的PCOS患者的妊娠率略高于年轻组，因为PCOS患者可能具有较好的卵巢储备。
