OVO Clinic, Montreal Quebec, Canada; Department of Obstetrics and Gynecology, University of Montreal, Montreal Quebec, Canada.
OVO Clinic, Montreal Quebec, Canada; Department of Obstetrics and Gynecology, University of Montreal, Montreal Quebec, Canada.
Reprod Biomed Online. 2019 Sep;39(3):461-466. doi: 10.1016/j.rbmo.2019.04.011. Epub 2019 Apr 25.
Do live birth rates (LBR) following modified natural IVF (mnIVF) differ according to serum anti-Müllerian hormone (AMH) concentration?
Retrospective cohort study including 638 women aged ≤39 years starting their first mnIVF cycle at a university-affiliated private IVF centre. Patients were divided into three groups, by concentration of AMH: ≤0.5 ng/ml (25th percentile), 0.51-2.03 ng/ml (25-75th percentile, reference) and 2.04-6.56 ng/ml (75th percentile). Analyses were stratified by AMH percentile and the age of patients (<35, 35-39 years). Logistic regression assessed the impact of age and AMH percentile on outcomes. LBR was the primary outcome measure.
LBR per started cycle were comparable across AMH percentiles (11.6%, 12.4% and 17.0% for the 25th, 25-75th and 75th percentile, respectively). No statistically significant difference was found between the three AMH groups with respect to cancellation, successful egg retrieval, embryo transfer, or biochemical and clinical pregnancy rates. Logistic regression analysis did not identify AMH percentile as a significant predictor of live birth. Compared with the reference group, the odds ratios (OR [95% confidence interval, CI]) for live birth in the <25th and >75th AMH percentile groups were 0.97 (0.54-1.76) and 1.41 (0.82-2.41), respectively. The results were the same regardless of age group (<35 years, 35-39 years).
Serum AMH cannot be used to predict mnIVF outcomes. Patients in lower/upper AMH percentiles showed pregnancy and LBR comparable to patients with normal AMH.
经过改良自然体外受精（mnIVF）后，活产率（LBR）是否因血清抗苗勒管激素（AMH）浓度而异？
这是一项回顾性队列研究，纳入了在一家大学附属私立 IVF 中心进行首次 mnIVF 周期的 638 名年龄≤39 岁的女性患者。患者按 AMH 浓度分为三组：≤0.5ng/ml（25 百分位）、0.51-2.03ng/ml（25-75 百分位，参考值）和 2.04-6.56ng/ml（75 百分位）。分析按 AMH 百分位和患者年龄（<35 岁、35-39 岁）分层。逻辑回归评估了年龄和 AMH 百分位对结果的影响。活产率是主要的结局指标。
在 AMH 百分位中，每个启动周期的活产率相似（25 百分位、25-75 百分位和 75 百分位的活产率分别为 11.6%、12.4%和 17.0%）。在取消、成功取卵、胚胎移植或生化和临床妊娠率方面，三个 AMH 组之间没有统计学上的显著差异。逻辑回归分析未发现 AMH 百分位是活产的显著预测因子。与参考组相比，<25 百分位和>75 百分位 AMH 组的活产比值比（OR [95%置信区间，CI]）分别为 0.97（0.54-1.76）和 1.41（0.82-2.41）。无论年龄组（<35 岁，35-39 岁），结果均相同。
血清 AMH 不能用于预测 mnIVF 结局。低/高 AMH 百分位的患者与 AMH 正常的患者相比，妊娠和活产率相当。
