IVF Department, IVI Middle-East Fertility Clinic, Abu Dhabi, UAE; IVF Department, IVI Middle-East Fertility Clinic, Dubai, UAE.
IVF Department, IVI Middle-East Fertility Clinic, Abu Dhabi, UAE.
Reprod Biomed Online. 2020 Jul;41(1):119-127. doi: 10.1016/j.rbmo.2020.03.014. Epub 2020 Apr 28.
This study explored the relationship between anti-Müllerian hormone (AMH) and oocyte survival after vitrification. The association between AMH and blastocyst formation after oocyte vitrification was also assessed.
A retrospective observational analysis was performed in a private IVF centre. A total of 4507 metaphase-II warmed oocytes were included from 450 couples, predominantly of Arab ethnicity. Between August 2015 and August 2018, couples underwent 484 intracytoplasmic sperm injection (ICSI) treatments using vitrified-warmed oocytes.
Patients' median age ± SD was 36.2 ± 6.1 years, AMH concentration 2.6 ± 3.4 ng/ml and body mass index (BMI) 26.5 ± 4.6 kg/m. The oocyte survival rate after vitrification was 87.37 ± 20.42%. AMH concentration showed a significant correlation (Kendall's tau 0.087, P = 0.0079) with oocyte survival rate independent of oocyte yield. Correlation was significant (odds ratio 1.041, 95% confidence interval 1.007-1.077, P = 0.018) when a multivariant model was applied that included AMH, age and BMI. The receiver operating characteristic curve showed an AMH cut-off value of 1.09 ng/ml that could obtain at least a 70% survival rate, with an area under the curve of 0.669. Regarding embryo development in ICSI cycles including fresh and warmed oocytes for the same patient, blastocyst formation rate was higher in fresh compared with warmed oocytes (P < 0.001). In this subgroup no significant correlation was seen between fertilization or blastocyst rate and AMH concentration.
AMH concentration showed a significant correlation with oocyte survival. Blastocyst formation was significantly lower after oocyte vitrification, but no correlation was found with AMH. Clinicians should carefully evaluate oocyte vitrification for patients with AMH below 1.09 ng/ml and consider embryo accumulation for these patients in preference to oocyte accumulation.
本研究探讨了抗苗勒管激素（AMH）与卵母细胞玻璃化冷冻后存活的关系。还评估了 AMH 与卵母细胞玻璃化冷冻后囊胚形成的关系。
在一家私立试管婴儿中心进行了回顾性观察性分析。纳入了 450 对夫妇的 4507 枚中期 II 期解冻卵母细胞，主要来自阿拉伯裔。2015 年 8 月至 2018 年 8 月，使用玻璃化冷冻解冻卵母细胞进行了 484 次胞浆内单精子注射（ICSI）治疗。
患者的中位年龄±标准差为 36.2±6.1 岁，AMH 浓度为 2.6±3.4ng/ml，体重指数（BMI）为 26.5±4.6kg/m。玻璃化冷冻后卵母细胞存活率为 87.37±20.42%。AMH 浓度与卵母细胞存活率呈显著相关（Kendall's tau 0.087，P=0.0079），独立于卵母细胞产量。当应用包括 AMH、年龄和 BMI 的多变量模型时，相关性具有统计学意义（优势比 1.041，95%置信区间 1.007-1.077，P=0.018）。受试者工作特征曲线显示，AMH 截断值为 1.09ng/ml 时，可获得至少 70%的存活率，曲线下面积为 0.669。关于同一患者新鲜和解冻卵母细胞的 ICSI 周期中胚胎发育，新鲜卵母细胞的囊胚形成率高于解冻卵母细胞（P<0.001）。在这个亚组中，受精率或囊胚率与 AMH 浓度之间未见显著相关性。
AMH 浓度与卵母细胞存活率呈显著相关。卵母细胞玻璃化冷冻后囊胚形成率显著降低，但与 AMH 无关。对于 AMH 低于 1.09ng/ml 的患者，临床医生应仔细评估卵母细胞玻璃化冷冻，优先考虑为这些患者积累胚胎，而不是卵母细胞。
