Division of Reproductive Endocrinology & Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT 06510, USA.
Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT 06510, USA.
J Clin Endocrinol Metab. 2021 Aug 18;106(9):2754-2766. doi: 10.1210/clinem/dgab168.
Antimüllerian hormone (AMH) level is strongly associated with ovarian response in assisted reproductive technology (ART) cycles but is a poor predictor of live birth. It is unknown whether AMH is associated with cumulative live birth rates (CLBRs) in women with diminished ovarian reserve (DOR).
To examine the association between serum AMH and CLBR among women with DOR undergoing ART.
Retrospective analysis of Society for Assisted Reproductive Technology Clinic Outcome Reporting System database 2014-16. A total of 34 540 index retrieval cycles of women with AMH <1 ng/mL. The main outcome measure was cumulative live birth.
A total of 34 540 (25.9%) cycles with AMH <1 ng/mL out of 133 442 autologous index retrieval cycles were analyzed. Cycles with preimplantation genetic testing or egg/embryo banking were excluded. Data were stratified according to AMH and, age and regression analysis of AMH and CLBR was performed for each age stratum. Multiple logistic regression demonstrated that AMH is an independent predictor of CLBR (odds ratio [OR] 1.39, 95% CI 1.18-1.64). Serum AMH was strongly associated with number of oocytes retrieved, embryos cryopreserved, mean number of cumulative embryos transferred, and percentage of cycles that had an embryo transfer. Linear regression analysis demonstrated that AMH highly correlated with CLBR in each age stratum.
Serum AMH is highly correlated with CLBR in women with DOR independent of age. The addition of AMH to current age-based prognostication counseling particularly in women with DOR would provide more informative and personalized CLBR prediction prior to ART.
抗缪勒管激素（AMH）水平与辅助生殖技术（ART）周期中的卵巢反应密切相关，但对活产的预测能力较差。目前尚不清楚 AMH 是否与卵巢储备功能减退（DOR）女性的累积活产率（CLBR）相关。
检查 AMH 与接受 ART 的 DOR 女性 CLBR 之间的关联。
对 2014 年至 2016 年的辅助生殖技术学会临床结果报告系统数据库进行回顾性分析。共分析了 34540 例 AMH<1ng/ml 的女性的索引检索周期。主要观察指标为累积活产。
共分析了 133442 例自体索引检索周期中 34540 例（25.9%）AMH<1ng/ml 的周期。排除了植入前遗传学检测或卵/胚胎冷冻保存的周期。根据 AMH 和年龄对数据进行分层，并对每个年龄组的 AMH 和 CLBR 进行回归分析。多因素逻辑回归表明，AMH 是 CLBR 的独立预测因子（优势比[OR]1.39，95%可信区间[CI]1.18-1.64）。血清 AMH 与获卵数、可冷冻胚胎数、累积移植胚胎的平均数量和进行胚胎移植的周期百分比密切相关。线性回归分析表明，在每个年龄组中，AMH 与 CLBR 高度相关。
在 DOR 女性中，血清 AMH 与 CLBR 高度相关，与年龄无关。在 ART 之前，将 AMH 添加到当前基于年龄的预测咨询中，特别是在 DOR 女性中，可以提供更具信息量和个性化的 CLBR 预测。
