First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
Reprod Biomed Online. 2021 Apr;42(4):842-848. doi: 10.1016/j.rbmo.2020.12.010. Epub 2020 Dec 26.
What is the association between serum anti-Müllerian hormone (AMH) concentrations and the number of utilizable embryos obtained per stimulation cycle of IVF/intracytoplasmic sperm injection (ICSI) in POSEIDON Groups 3 and 4?
Retrospective cohort study of 412 cycles, in which patients in POSEIDON Groups 3 and 4 (antral follicle count [AFC] ≤5 and AMH <1.2 ng/ml) underwent complete IVF/ICSI treatment cycles in the Reproductive Center of the First Affiliated Hospital of Xinjiang Medical University between January 2017 and March 2019. Patients underwent IVF/ICSI treatment using either progestin-primed ovarian stimulation (PPOS) or gonadotrophin-releasing hormone (GnRH) antagonist protocol as ovarian stimulation protocol.
Three models were established to analyse the correlation between AMH and the number of utilizable embryos in this study. After adjusting for covariates (age, baseline FSH, stimulation protocol and AFC), the number of embryos increased by 0.1 (95% confidence interval [CI] 0.06-0.14) with each increment of 0.1 ng/ml in AMH concentration. AMH was transformed from a continuous variable to a categorical variable (through trisection of AMH concentrations) and for the sensitivity analysis it was found that the number of embryos in the high AMH group (0.52-1.19 ng/ml) was 0.62 (95% CI 0.37-0.97) higher than in the low AMH group (0.06-0.24 ng/ml).
High AMH in patients in POSEIDON Groups 3 and 4 was found to be associated with an increase in the number of available embryos in IVF/ICSI. The potential reproductive prognosis can be assessed by AMH, to reduce the abandonment of treatment due to underestimation or to implement multiple ineffective stimulation cycles of treatment.
在 POSEIDON 分组 3 和 4 中，血清抗苗勒管激素（AMH）浓度与每个体外受精/胞浆内单精子注射（ICSI）刺激周期获得的可利用胚胎数量之间存在何种关联？
这是一项回顾性队列研究，共纳入了 412 个周期，患者为 POSEIDON 分组 3 和 4（窦卵泡计数 [AFC] ≤5 且 AMH<1.2ng/ml），于 2017 年 1 月至 2019 年 3 月在新疆医科大学第一附属医院生殖中心接受完整的体外受精/ICSI 治疗周期。患者采用孕激素预激卵巢刺激（PPOS）或促性腺激素释放激素（GnRH）拮抗剂方案作为卵巢刺激方案进行 IVF/ICSI 治疗。
本研究建立了 3 个模型来分析 AMH 与可利用胚胎数量之间的相关性。在调整了协变量（年龄、基础 FSH、刺激方案和 AFC）后，AMH 浓度每增加 0.1ng/ml，胚胎数量增加 0.1（95%置信区间 [CI] 0.06-0.14）。AMH 被转换为连续变量和分类变量（通过 AMH 浓度的三分位），并进行敏感性分析，结果发现高 AMH 组（0.52-1.19ng/ml）的胚胎数量比低 AMH 组（0.06-0.24ng/ml）高 0.62（95%CI 0.37-0.97）。
POSEIDON 分组 3 和 4 的患者中 AMH 水平较高与 IVF/ICSI 中可利用胚胎数量的增加有关。通过 AMH 评估潜在的生殖预后，可以减少因低估而放弃治疗或实施多次无效的治疗刺激周期。
