Massachusetts General Hospital Fertility Center, Department of Obstetrics, Gynecology, and Reproductive Biology, Division of Reproductive Endocrinology and Infertility, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.
Department of Obstetrics and Gynecology, Tufts Medical Center, 800 Washington Street, Boston, MA, 02111, USA.
J Assist Reprod Genet. 2023 Apr;40(4):845-850. doi: 10.1007/s10815-023-02736-9. Epub 2023 Feb 6.
To study the association, if any, between anti-Müllerian hormone (AMH) and pre-ovulatory endometrial thickness (ET) in gonadotropin/intrauterine insemination (IUI) cycles.
This retrospective cohort study included a total of 964 patients undergoing 1926 gonadotropin/IUI cycles at an academic fertility center. Primary outcome measure was the association between serum AMH and measured ET on the day of and the day before human chorionic gonadotropin hormone (hCG) ovulation trigger. The effect of a model combining AMH and ET on early pregnancy outcomes was a secondary measure.
In 52.8% of cycles, ET was last assessed and recorded on the day of hCG administration, while in the remaining 47.2% on the day prior to trigger. In unadjusted regression models, AMH was weakly correlated with ET on hCG trigger day [b (95%CI) = 0.032 (- 0.008, 0.070), p = 0.015]. When adjusting for potential confounders, the positive correlation became significant [0.051 (0.006, 0.102), p = 0.047]. Similar findings were observed when assessing the correlation between AMH and ET on the day prior to hCG trigger. ET was non-significantly associated with the odds of clinical pregnancy, when adjusting for potential confounders, except for when restricting the analysis to couples with idiopathic infertility [OR (95%CI), p-value: 0.787 (0.623, 0.993), 0.044].
Our findings support an effect of serum AMH on endometrial development in gonadotropin induced cycles, even when adjusting for the diagnosis of PCOS. ET was not associated with the odds of achieving a clinical pregnancy, except for couples with idiopathic infertility.
研究抗苗勒管激素（AMH）与促性腺激素/宫腔内人工授精（IUI）周期中排卵前子宫内膜厚度（ET）之间是否存在关联。
本回顾性队列研究共纳入 964 名在学术生育中心接受 1926 个促性腺激素/IUI 周期的患者。主要观察指标是血清 AMH 与 hCG 排卵扳机日和前一日测量的 ET 之间的关系。次要观察指标是结合 AMH 和 ET 对早期妊娠结局的影响。
在 52.8%的周期中，ET 是在 hCG 给药日进行最后评估和记录的，而在其余 47.2%的周期中是在扳机前一日进行的。在未调整的回归模型中，AMH 与 hCG 扳机日的 ET 呈弱相关[b（95%CI）=0.032（-0.008，0.070），p=0.015]。当调整潜在混杂因素后，这种正相关变得显著[0.051（0.006，0.102），p=0.047]。当评估 AMH 与 hCG 扳机前一日的 ET 之间的相关性时，也观察到了类似的发现。在调整潜在混杂因素后，ET 与临床妊娠的可能性呈非显著相关，除了在限制分析为特发性不孕的夫妇时[OR（95%CI），p 值：0.787（0.623，0.993），0.044]。
我们的研究结果支持 AMH 对促性腺激素诱导周期中子宫内膜发育的影响，即使在调整 PCOS 诊断后也是如此。ET 与临床妊娠的可能性无关，除了特发性不孕的夫妇。
