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血清高抗苗勒管激素浓度对受精和胚胎发育率有负面影响。

High serum anti-Müllerian hormone concentrations have a negative impact on fertilization and embryo development rates.

机构信息

Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; School of Medicine, Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei, Taiwan; Institute of BioPharmaceutical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan.

Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.

出版信息

Reprod Biomed Online. 2022 Jan;44(1):171-176. doi: 10.1016/j.rbmo.2021.08.016. Epub 2021 Aug 24.

Abstract

RESEARCH QUESTION

What is the impact of high serum anti-Müllerian hormone (AMH) concentrations on fertilization and embryo development among infertile women undergoing treatment with assisted reproductive technology (ART)?

DESIGN

Retrospective study of 1036 infertile women undergoing ART; women were divided into three groups according to serum AMH concentrations: AMH <1.1 ng/ml, 1.1-5.0 ng/ml and >5.0 ng/ml. The fertilization and embryo development rates of patients with different AMH concentrations and after stratification according to age were compared.

RESULTS

Women with high AMH concentrations were younger and had higher testosterone concentrations (0.4 ± 0.13 versus 0.3 ± 0.12 versus 0.3 ± 0.08 µg/dl, P < 0.001) than women with low AMH concentrations. However, analysis of the embryo development rate showed negative outcomes for women with high AMH concentrations, including a poor fertilization rate (76.3 ± 17.36 versus 82.1 ± 19.15 versus 82.4 ± 25.38, P = 0.003), and poor day 3 embryo development rate (55.6 ± 23.88 versus 62.6 ± 26.52 versus 62.8 ± 32.65, P = 0.014). Multivariate linear regression analysis showed significantly negative correlations of the AMH concentrations with the fertilization rate (P < 0.001) and day 3 embryo development rate (P = 0.006). Subgroup analysis showed that age 30 years or younger had a significant negative correlation with AMH and the embryo development rate, including the fertilization rate (P < 0.001) and day 3 embryo development rate (P = 0.037).

CONCLUSION

These results suggest that high serum AMH concentrations, contributing to a hyperandrogenic environment and leading to decreased oocyte developmental competence, may have a negative impact on fertilization and the early stage of embryo development in women undergoing treatment with ART.

摘要

研究问题

在接受辅助生殖技术(ART)治疗的不孕女性中,高血清抗苗勒管激素(AMH)浓度对受精和胚胎发育有何影响?

设计

对 1036 名接受 ART 的不孕女性进行回顾性研究;根据血清 AMH 浓度将女性分为三组:AMH<1.1ng/ml、1.1-5.0ng/ml 和>5.0ng/ml。比较不同 AMH 浓度患者的受精和胚胎发育率,并按年龄分层比较。

结果

高 AMH 浓度组的女性年龄较小,且睾酮浓度较高(0.4±0.13 与 0.3±0.12 与 0.3±0.08µg/dl,P<0.001)。然而,胚胎发育率分析显示高 AMH 浓度的女性结果较差,包括受精率较低(76.3±17.36 与 82.1±19.15 与 82.4±25.38,P=0.003),以及第 3 天胚胎发育率较低(55.6±23.88 与 62.6±26.52 与 62.8±32.65,P=0.014)。多元线性回归分析显示 AMH 浓度与受精率(P<0.001)和第 3 天胚胎发育率呈显著负相关(P<0.001)。亚组分析显示,30 岁或以下的年龄与 AMH 和胚胎发育率呈显著负相关,包括受精率(P<0.001)和第 3 天胚胎发育率(P=0.037)。

结论

这些结果表明,高血清 AMH 浓度导致高雄激素环境,降低卵母细胞发育能力,可能对接受 ART 治疗的女性的受精和胚胎早期发育产生负面影响。

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