Reproductive Medical Center, Department of Obstetrics and Gynecology, Southwest Hospital, Third Military Medical University (Army Medical University, Chongqing, China.
Int J Gynaecol Obstet. 2021 Sep;154(3):451-458. doi: 10.1002/ijgo.13567. Epub 2021 Feb 11.
To investigate new risk factors for female fertility by analyzing the effects of environmental, social, and surgical factors on antral follicle counts (AFC) and anti-Müllerian hormone (AMH) levels.
A total of 1513 women aged 20-47 years who underwent in vitro fertilization/intracytoplasmic injection treatment in Southwest Hospital from December 2017 to December 2019 were included. Women were assessed for AFC and AMH levels, and completed a questionnaire. Ordinal logistic regression analyses with generalized linear mixed models were used to calculate the adjusted odds ratio (OR) for diminished ovarian reserve.
Adnexal surgery was the only risk factor associated with low AFC in women aged 20-30 years. Younger age at menarche, alcohol drinking, and adnexal surgery are three independent risk factors for AMH decline in women aged 20-30 years. Intense exercise, sleep quality, and adnexal surgery are three independent risk factors for a low AFC in women aged 31-36 years. Alcohol drinking and adnexal surgery are two independent risk factors for AMH decline in women aged 31-36 years.
With age, female fertility becomes sensitive to high-intensity exercise and poor sleep quality. Adnexal surgery and alcohol drinking are two important risk factors for female fertility in women under age 37 years.
通过分析环境、社会和手术因素对窦卵泡计数（AFC）和抗苗勒管激素（AMH）水平的影响，探讨女性生育力的新的危险因素。
选取 2017 年 12 月至 2019 年 12 月在西南医院接受体外受精/卵胞浆内单精子注射治疗的 1513 名 20-47 岁女性。评估女性的 AFC 和 AMH 水平，并完成问卷。采用广义线性混合模型的有序逻辑回归分析计算卵巢储备功能减退的调整比值比（OR）。
附件手术是 20-30 岁女性低 AFC 的唯一危险因素。初潮年龄较小、饮酒和附件手术是 20-30 岁女性 AMH 下降的三个独立危险因素。剧烈运动、睡眠质量和附件手术是 31-36 岁女性 AFC 降低的三个独立危险因素。饮酒和附件手术是 31-36 岁女性 AMH 下降的两个独立危险因素。
随着年龄的增长，女性生育力对高强度运动和睡眠质量差变得敏感。附件手术和饮酒是 37 岁以下女性生育力的两个重要危险因素。
