Department of Obstetrics and Gynecology, Clinique La Sagesse, Rennes, France.
Department de Medecine de La Reproduction, Centre Medico-Chirurgical Et Obstetrical (CMCO), 19 rue Louis Pasteur, 67300, Schiltigheim, France.
J Assist Reprod Genet. 2022 May;39(5):1045-1053. doi: 10.1007/s10815-022-02449-5. Epub 2022 Mar 3.
Anti-Müllerian hormone (AMH) and antral follicle count (AFC) are correlated with the ovarian response, but their reliability and reproducibility are questionable. This large multicenter study describes their distribution, inter-cycle and inter-center variability, and their correlation.
A total of 25,854 IVF cycles among 15,219 patients were selected in 12 ART centers. Statistical distribution of AMH and AFC was studied by using the Kolmogorov-Smirnov test and Shapiro goodness of fit test. The reproducibility of AFC and AMH was measured using a mixed model regressing the logarithmic transformation of AFC with age.
The distribution of AMH and AFC was characterized by a wide dispersion of values, twice more important for AFC, and a logarithmic distribution. The faster decline in AMH than in AFC with age suggests that their correlation changes with age. AMH and AFC showed a very low proportion of concordance in the range of expected poor responders according to Bologna cutoffs. The heterogeneity for AMH and AFC across centers was small, but much larger across patients within each center. Concerning the patients with several successive cycles, the reproducibility for AMH seemed much better than for AFC. Comparing respective performances of AMH and AFC for the prediction of ovarian response depended on the local conditions for measuring these indicators and on the reproducibility of results improved over time.
Distribution of AMH and AFC was characterized by the wide dispersion of values, and a logarithmic distribution. Establishing cutoffs or a direct relationship AMH/AFC without considering age seems hazardous. Correlation between AMH and AFC was very poor in the range of poor responders.
抗苗勒管激素（AMH）和窦卵泡计数（AFC）与卵巢反应相关，但它们的可靠性和可重复性存在疑问。这项大型多中心研究描述了它们的分布、周期内和中心间的变异性以及它们的相关性。
在 12 个 ART 中心选择了 15219 名患者的 25854 个 IVF 周期。使用 Kolmogorov-Smirnov 检验和 Shapiro 拟合优度检验研究 AMH 和 AFC 的统计分布。使用混合模型回归 AFC 的对数转换与年龄，测量 AFC 和 AMH 的重现性。
AMH 和 AFC 的分布特征为值的离散度较大，AFC 的离散度更大，呈对数分布。随着年龄的增长，AMH 的下降速度快于 AFC，表明它们的相关性随年龄而变化。根据博洛尼亚标准，在预期反应不良者的范围内，AMH 和 AFC 的一致性比例非常低。各中心之间 AMH 和 AFC 的异质性较小，但每个中心内患者之间的异质性要大得多。对于有多个连续周期的患者，AMH 的重现性似乎优于 AFC。比较 AMH 和 AFC 各自对卵巢反应的预测性能取决于当地测量这些指标的条件以及随着时间的推移结果重现性的提高。
AMH 和 AFC 的分布特征为值的离散度较大，呈对数分布。不考虑年龄而建立 AMH/AFC 的截断值或直接关系似乎有风险。在反应不良者的范围内，AMH 和 AFC 之间的相关性非常差。
