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抗苗勒管激素和窦卵泡计数在预测波塞冬3组和4组患者首次完整卵巢刺激周期的累积治疗结局方面能力有所不同。

Anti-Müllerian hormone and antral follicle count differ in their ability to predict cumulative treatment outcomes of the first complete ovarian stimulation cycle in patients from POSEIDON groups 3 and 4.

作者信息

Liu Luxin, Zhou Canquan

机构信息

Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.

Guangdong Provincial Key Laboratory of Reproductive Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.

出版信息

J Obstet Gynaecol Res. 2020 Sep;46(9):1801-1808. doi: 10.1111/jog.14269. Epub 2020 Jul 19.

Abstract

AIM

To explore the ability of anti-Müllerian hormone and antral follicle count to predict cumulative live birth and clinical pregnancy in the first complete ovarian stimulation cycle among patients from POSEIDON (Patient-Oriented Strategies Encompassing IndividualizeD Oocyte Number) groups 3-4.

METHODS

A single-center retrospective study was conducted on 260 patients in POSEIDON groups 3-4 (antral follicle count <5 and/or anti-Müllerian hormone <1.2 ng/mL) who first underwent complete in vitro fertilization/intracytoplasmic sperm injection cycles between January 2016 and June 2018. The main outcomes were cumulative live birth rate and cumulative clinical pregnancy rate.

RESULTS

Of 260 patients, 113 (43.5%) achieved clinical pregnancy and 82 (31.5%) achieved live birth in their first complete ovarian stimulation cycles. With multivariate regression analysis, age and antral follicle count were significantly correlated with cumulative clinical pregnancy, whereas age and anti-Müllerian hormone were significantly associated with cumulative live birth. Receiver operating characteristic curve analysis demonstrated that age had the highest accuracy for the prediction of cumulative treatment outcomes. The optimal cut-off value of age was 40.5 and that of antral follicle count was 2.5 for predicting cumulative clinical pregnancy. The optimal cut-off value of age was 36.5 and that of anti-Müllerian hormone was 0.725 for predicting cumulative live birth.

CONCLUSION

Our findings indicate that anti-Müllerian hormone is a better predictor of cumulative live birth than antral follicle count, independent of age, in the first complete ovarian stimulation cycle of in vitro fertilization/intracytoplasmic sperm injection among patients in POSEIDON groups 3-4.

摘要

目的

探讨抗苗勒管激素(AMH)和窦卵泡计数(AFC)对POSEIDON(以患者为导向的个体化卵子数量策略)3-4组患者首次完整卵巢刺激周期中累积活产和临床妊娠的预测能力。

方法

对2016年1月至2018年6月期间首次接受完整体外受精/卵胞浆内单精子注射周期的260例POSEIDON 3-4组患者(窦卵泡计数<5个和/或抗苗勒管激素<1.2 ng/mL)进行单中心回顾性研究。主要结局为累积活产率和累积临床妊娠率。

结果

260例患者中,113例(43.5%)在首次完整卵巢刺激周期中实现临床妊娠,82例(31.5%)实现活产。多因素回归分析显示,年龄和窦卵泡计数与累积临床妊娠显著相关,而年龄和抗苗勒管激素与累积活产显著相关。受试者工作特征曲线分析表明,年龄对累积治疗结局的预测准确性最高。预测累积临床妊娠时,年龄的最佳截断值为40.5,窦卵泡计数的最佳截断值为2.5。预测累积活产时,年龄的最佳截断值为36.5,抗苗勒管激素的最佳截断值为0.725。

结论

我们的研究结果表明,在POSEIDON 3-4组患者首次完整体外受精/卵胞浆内单精子注射卵巢刺激周期中,抗苗勒管激素比窦卵泡计数更能预测累积活产,且不受年龄影响。

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