Hosseinzadeh Fatemeh, Kabodmehri Roya, Mehrafza Marzieh, Mansour-Ghanaei Mandana, Sorouri Ziba Zahiri, Gashti Nasrin Ghanami, Hanifi Sakineh, Ghalandari Maryam
Reproductive Health Research Center, Department of Obstetrics & Gynecology, School of Medicine, Al-Zahra Hospital, Guilan University of Medical Sciences, Rasht, Iran.
Mehr Fertility Research Center, Guilan University of Medical Sciences, Rasht, Iran.
J Obstet Gynaecol India. 2022 Oct;72(5):420-425. doi: 10.1007/s13224-021-01582-y. Epub 2022 Apr 19.
Despite many advances, patients with a poor ovarian response to stimulation are one of the most important and challenging factors of infertility. Chronological and ovarian ages are two effective factors responsible for poor response to assisted reproduction treatment. The purpose of this study was to determine the effect of age and AMH level on the in vitro fertilization (IVF) outcomes in participants with a reduced ovarian reserve.
In this retrospective cross-sectional study, 210 participants with anti-Mullerian hormone (AMH) < 1.1 ng/ml were included. The effect of age and AMH on pregnancy outcomes including dominant follicle count, serum estradiol level on the day of trigger administration, number of metaphase II (MII) oocytes, number of embryos, biochemical pregnancy, clinical pregnancy, abortion and live birth rate were evaluated.
The number of dominant follicle ( < 0.001), MII oocyte ( < 0.001), grade A ( < 0.001) and B ( < 0.001) embryos, serum estradiol level ( < 0.001), gonadotropin level ( < 0.001), AMH ( = 0.001), biochemical pregnancy ( = 0.007), clinical ( = 0.01) pregnancy, and live birth rate ( = 0.003) were higher in participants younger than 35 years old. In univariable logistic regression, the chance of retrieving more than 3 oocytes in individuals over 35 years old was 97.1% lower than in individuals younger than 35 years old ( < 0.001).
It has been concluded that the higher clinical pregnancy and live birth rate in participants younger than 35 years can be due to the higher AMH level in this group. Under the same conditions of AMH and other variables, age can affect the number of retrieved oocytes.
尽管取得了许多进展,但卵巢对刺激反应不良的患者是不孕症最重要且最具挑战性的因素之一。实际年龄和卵巢年龄是辅助生殖治疗反应不良的两个有效因素。本研究的目的是确定年龄和抗苗勒管激素(AMH)水平对卵巢储备减少的参与者体外受精(IVF)结局的影响。
在这项回顾性横断面研究中,纳入了210名抗苗勒管激素(AMH)<1.1 ng/ml的参与者。评估年龄和AMH对妊娠结局的影响,包括优势卵泡数量、扳机日血清雌二醇水平、中期II(MII)卵母细胞数量、胚胎数量、生化妊娠、临床妊娠、流产和活产率。
35岁以下参与者的优势卵泡数量(<0.001)、MII卵母细胞数量(<0.001)、A级(<0.001)和B级(<0.001)胚胎数量、血清雌二醇水平(<0.001)、促性腺激素水平(<0.001)、AMH(=0.001)、生化妊娠(=0.007)、临床妊娠(=0.01)和活产率(=0.003)更高。在单变量逻辑回归中,35岁以上个体获得超过3个卵母细胞的机会比35岁以下个体低97.1%(<0.001)。
得出的结论是,35岁以下参与者较高的临床妊娠和活产率可能归因于该组较高的AMH水平。在AMH和其他变量相同的条件下,年龄会影响获得的卵母细胞数量。