Institute of Reproductive Health, Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China.
Department of Reproductive Medicine Center, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital of Henan University, Zhengzhou, Henan, P.R. China.
Arch Gynecol Obstet. 2021 Dec;304(6):1611-1620. doi: 10.1007/s00404-021-06108-5. Epub 2021 May 30.
To investigate the predictive value of AMH level for pregnancy outcomes in different age groups of IVF/ICSI patients.
The study was a cohort study that included 11,484 patients that had their first IVF/ICSI procedure between 2016 and 2019. All patients who met the inclusion and exclusion criteria were divided into 6 groups according to 5-year age intervals, namely, Group 1: 20-24 years (n = 725); Group 2: 25-29 years (n = 4019); Group 3: 30-34 years (n = 3600); Group 4: 35-39 years (n = 1915); Group 5: 40-44 years (n = 1006); and Group 6: ≥ 45 years (n = 219).
Receiver operating characteristic (ROC) curve analysis revealed that AMH level could only predict the outcome of live birth in Group 3 and Group 4 (p < 0.05). The area under the curve (AUC) of Group 3 was 0.536 (95% CI 0.510-0.561, p = 0.006), and that of Group 4 was 0.562 (95% CI 0.527-0.598, p = 0.001). The cutoff values of AMH for predicting live birth in Group 3 and Group 4 were 1.84 ng/ml and 1.86 ng/ml, respectively. Further logistic regression analysis showed that only the cutoff values of AMH and age could predict live birth in Groups 3 and 4.
AMH level could predict live birth in IVF/ICSI patients at the age of 30-39. However, it could not be used to predict live birth in patients < 30 years or ≥ 40 years.
探讨抗缪勒管激素(AMH)水平对不同年龄组体外受精/卵胞浆内单精子注射(IVF/ICSI)患者妊娠结局的预测价值。
本研究为队列研究,纳入 2016 年至 2019 年间进行首次 IVF/ICSI 治疗的 11484 例患者。所有符合纳入和排除标准的患者根据 5 年年龄间隔分为 6 组,分别为:第 1 组:20-24 岁(n=725);第 2 组:25-29 岁(n=4019);第 3 组:30-34 岁(n=3600);第 4 组:35-39 岁(n=1915);第 5 组:40-44 岁(n=1006);第 6 组:≥45 岁(n=219)。
受试者工作特征(ROC)曲线分析显示,AMH 水平仅能预测第 3 组和第 4 组的活产结局(p<0.05)。第 3 组的曲线下面积(AUC)为 0.536(95%CI 0.510-0.561,p=0.006),第 4 组为 0.562(95%CI 0.527-0.598,p=0.001)。第 3 组和第 4 组预测活产的 AMH 截断值分别为 1.84ng/ml 和 1.86ng/ml。进一步的 logistic 回归分析显示,仅 AMH 截断值和年龄可预测第 3 组和第 4 组的活产。
AMH 水平可预测 30-39 岁 IVF/ICSI 患者的活产,但不能用于预测<30 岁或≥40 岁患者的活产。