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体外受精治疗女性中抗苗勒管激素水平低的年龄特异性定义及相关妊娠结局

Age-specific definition of low anti-Mullerian hormone and associated pregnancy outcome in women undergoing IVF treatment.

作者信息

Zhao Depeng, Fan Jing, Wang Ping, Jiang Xuan, Yao Jilong, Li Xuemei

机构信息

Department of Reproductive Medicine, Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China.

出版信息

BMC Pregnancy Childbirth. 2021 Mar 5;21(1):186. doi: 10.1186/s12884-021-03649-0.

Abstract

BACKGROUND

The age-specific definition of low anti-müllerian hormone (AMH) is lacking. This study aims to define an age-specific reference for low AMH and to evaluate the associated outcome in women undergoing IVF treatment.

METHODS

A retrospective study was performed in women receiving IVF treatment at the Shenzhen maternity and child healthcare hospital between September 2016 and September 2018. We excluded cases without AMH concentration. Polynomial least-squares regression was used to estimate the age-specific reference ranges for AMH after log-transformed. The age-specific 10 centile was defined as the threshold of low AMH concentration.

RESULTS

A total of 909 patients were analyzed in this study. The age-specific reference ranges for AMH were established using linear regression model and resulted in an age-specific equation for mean: mean of LnAMH = (- 0.085 × age) + 3.722 (ng/ml, in unit). Women with AMH level higher than 10 centile had favorable outcomes in ovarian stimulation compared to those with low AMH level. In patients younger than 35 years, the rates of clinical pregnancy per transfer and ongoing pregnancy per transfer in the subgroup with AMH level higher than 10 centile were significantly higher than that in the subgroup of low AMH level, 57% versus 31.3% p = 0.003 and 51.9% versus 21.9% p = 0.001, respectively.

CONCLUSION

Women with AMH lower than age-specific 10 centile had significantly unfavorable outcomes after IVF treatment. The age-specific 10 centile of AMH concentration may be useful to predict the outcome of IVF treatment.

摘要

背景

缺乏针对不同年龄的低抗苗勒管激素(AMH)的定义。本研究旨在确定针对不同年龄的低AMH参考标准,并评估接受体外受精(IVF)治疗的女性的相关结局。

方法

对2016年9月至2018年9月在深圳市妇幼保健院接受IVF治疗的女性进行回顾性研究。我们排除了没有AMH浓度数据的病例。采用多项式最小二乘回归法对经对数转换后的AMH进行年龄特异性参考范围估计。将年龄特异性第10百分位数定义为低AMH浓度的阈值。

结果

本研究共分析了909例患者。使用线性回归模型建立了AMH的年龄特异性参考范围,并得出了均值的年龄特异性方程:LnAMH的均值=(-0.085×年龄)+3.722(ng/ml,单位)。与AMH水平低的女性相比,AMH水平高于第10百分位数的女性在卵巢刺激方面有更好的结局。在年龄小于35岁的患者中,AMH水平高于第10百分位数的亚组中每次移植的临床妊娠率和持续妊娠率显著高于AMH水平低的亚组,分别为57%对31.3%,p=0.003和51.9%对21.9%,p=0.001。

结论

AMH低于年龄特异性第10百分位数的女性在IVF治疗后结局明显较差。AMH浓度的年龄特异性第10百分位数可能有助于预测IVF治疗的结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a6f5/7936413/53d7bc3021c3/12884_2021_3649_Fig1_HTML.jpg

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