高循环抗苗勒管激素对多囊卵巢综合征女性子宫内膜厚度及辅助生殖技术结局的影响：一项队列研究
The Impact of High Circulating Anti-Müllerian Hormone on Endometrial Thickness and Outcome of Assisted Reproductive Technology in Women with Polycystic Ovarian Syndrome: A Cohort Study.
作者信息
Mohamed Ahmed Aboelfadle, Al-Hussaini Tarek K, Hussein Reda S, Abdallah Karim S, Amer Saad A
机构信息
Department of Obstetrics and Gynaecology, Assiut University, Assiut, Egypt.
Department of Obstetrics and Gynaecology, Academic Unit of Translational Medical Sciences, School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK.
出版信息
J Hum Reprod Sci. 2022 Oct-Dec;15(4):370-376. doi: 10.4103/jhrs.jhrs_112_22. Epub 2022 Dec 30.
BACKGROUND
Elevated circulating anti-Müllerian hormone (AMH) in women with the polycystic ovarian syndrome (PCOS) has been found to have a detrimental effect on endometrial function. This may adversely affect the outcome of fertilisation (IVF) in PCOS women.
AIMS
To investigate the impact of high serum AMH concentrations on endometrial thickness (ET) and the outcome of IVF in women with PCOS.
SETTINGS AND DESIGN
This retrospective cohort study included all PCOS women who underwent fresh IVF\intracytoplasmic sperm injection cycles between January 2016 and December 2021 in one major IVF centre.
MATERIALS AND METHODS
PCOS diagnosis was based on Rotterdam criteria, and participants were identified from centre database. All women received antagonist protocol. Primary outcomes were trigger-day ET and live birth rate (LBR). Circulating AMH was correlated with ET and ovarian response.
STATISTICAL ANALYSIS USED
AMH levels were compared between women with and without live birth. ET and LBRs were compared between women with AMH <7.0 ng/ml versus those with AMH ≥7.0 ng/ml.
RESULTS
The study included 102 PCOS women, of which six were excluded due to poor response ( = 4), hyperresponse ( = 1) or fertilisation failure ( = 1). Of the remaining 96 women, 42 (43.8%) achieved a live birth. There was no statistically significant ( > 0.05) correlation between AMH and ET. Mean ± standard deviation AMH concentration was not significantly ( > 0.05) different between women with live birth (6.5 ± 3.4 ng/ml) and those without (6.5 ± 2.4 ng/ml). High AMH positively correlated with the number of oocytes retrieved, metaphase II oocytes and embryos ( = 0.003, 0.006 and 0.006, respectively). There was no statistically significant ( > 0.05) difference in ET or LBR between women with AMH <7.0 ng/ml ( = 72; ET, 10.7 ± 1.8 mm; LBR, 45.8% [33/72] versus those with AMH ≥7.0 ng/ml ( = 24; ET, 10.8 ± 1.7 mm; LBR, 37.5% [9/24]).
CONCLUSIONS
High circulating AMH in PCOS women does not seem to negatively affect ET or LBRs during assisted reproductive technology.
背景
多囊卵巢综合征（PCOS）女性循环抗苗勒管激素（AMH）升高已被发现对子宫内膜功能有不利影响。这可能会对PCOS女性的体外受精（IVF）结果产生不利影响。
目的
研究高血清AMH浓度对PCOS女性子宫内膜厚度（ET）和IVF结果的影响。
设置与设计
这项回顾性队列研究纳入了2016年1月至2021年12月期间在一个主要IVF中心接受新鲜IVF/卵胞浆内单精子注射周期的所有PCOS女性。
材料与方法
PCOS诊断基于鹿特丹标准，参与者从中心数据库中识别。所有女性均接受拮抗剂方案。主要结局为扳机日ET和活产率（LBR）。循环AMH与ET和卵巢反应相关。
所用统计分析
比较有活产和无活产女性的AMH水平。比较AMH<7.0 ng/ml与AMH≥7.0 ng/ml女性的ET和LBR。
结果
该研究纳入了102名PCOS女性，其中6名因反应不良（n = 4）、高反应（n = 1）或受精失败（n = 1）被排除。在其余96名女性中，42名（43.8%）实现了活产。AMH与ET之间无统计学显著相关性（P>0.05）。有活产女性（6.5±3.4 ng/ml）和无活产女性（6.5±2.4 ng/ml）的平均±标准差AMH浓度无显著差异（P>0.05）。高AMH与获卵数、中期II卵母细胞数和胚胎数呈正相关（分别为P = 0.003、0.006和0.006）。AMH<7.0 ng/ml的女性（n = 72；ET，10.7±1.8 mm；LBR，45.8%[33/72]）与AMH≥7.0 ng/ml的女性（n = 24；ET，10.8±1.7 mm；LBR，37.5%[9/24]）在ET或LBR方面无统计学显著差异（P>0.05）。
结论
PCOS女性循环AMH升高在辅助生殖技术期间似乎不会对ET或LBR产生负面影响。
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