抗苗勒管激素（AMH）和年龄作为预测体外受精（IVF）女性胚胎植入前遗传学检测（PGT-A）周期结局和第 5 天囊胚质量的指标。
Antimüllerian hormone (AMH) and age as predictors of preimplantation genetic testing for aneuploidies (PGT-A) cycle outcomes and blastocyst quality on day 5 in women undergoing in vitro fertilization (IVF).
机构信息
ART Fertility Clinics Abu Dhabi and Dubai, Embryology Lab and IVF Clinic, Dubai, United Arab Emirates.
Biomedicine and Biotechnology Department, University of Alcalá de Henares, Madrid, Spain.
出版信息
J Assist Reprod Genet. 2023 Jun;40(6):1467-1477. doi: 10.1007/s10815-023-02805-z. Epub 2023 May 5.
PURPOSE
The objective of this study was to investigate whether women with diminished ovarian reserve who planned for PGT-A exhibit a lower number of blastocysts for biopsy, ploidy outcomes, and blastocyst quality on day 5, regardless of age.
METHODS
A retrospective analysis was performed between March 2017 and July 2020 at ART Fertility Clinics Abu Dhabi, including couples that were triggered for final oocyte maturation in an ovarian stimulated cycle planned for PGT-A. Patients were stratified into four AMH groups: < 0.65 ng/ml, 0.65-1.29 ng/ml, 1.3-6.25 ng/ml, and > 6.25 ng/ml; four age categories: ≤ 30, 31-35, 36-40, and > 40 years.
MAIN RESULTS AND THE ROLE OF CHANCE
A total of 1410 couples with a mean maternal age of 35.2 ± 6.4 years and AMH of 2.7 ± 2.6 ng/ml were included. In a multivariate logistic regression analysis, controlling for age, the chance of having at least one blastocyst biopsied/stimulated cycle (1156/1410), the chance of having at least one euploid blastocyst/stimulated cycle (880/1410), and the chance of having one euploid blastocyst once biopsy was performed (880/1156) were affected in all patients with AMH < 0.65 ng/ml [AdjOR 0.18[0.11-0.31] p = 0.008)], [AdjOR 0.18 [0.11-0.29] p < 0.001], and [AdjOR 0.34 [0.19-0.61] p = 0.015] as well as in patients with AMH 0.65-1.29 ng/ml (AdjOR 0.52 [0.32-0.84] p < 0.001), (AdjOR 0.49 [0.33-0.72] p < 0.001), and (AdjOR 0.57 [0.36-0.90] p < 0.001), respectively. In a multivariate linear regression analysis, AMH values did not affect blastocyst quality (- 0.72 [- 1.03 to - 0.41] p < 0.001).
CONCLUSION
Irrespective of age, patients with diminished ovarian reserve (AMH < 1.3 ng/ml) have a lower chance of having at least one blastocyst biopsied and lower chance of having at least one euploid blastocyst per ovarian stimulated cycle. Blastocyst quality was not affected by AMH values.
目的
本研究旨在探讨是否无论年龄大小，计划进行 PGT-A 的卵巢储备功能降低的女性在进行卵母细胞活检时，活检的胚胎数量、胚胎倍性结果和第 5 天的胚胎质量均较低。
方法
2017 年 3 月至 2020 年 7 月在阿布扎比 ART 生育诊所进行了回顾性分析，包括在计划进行 PGT-A 的卵巢刺激周期中触发最终卵母细胞成熟的夫妇。患者被分为四组 AMH 组：<0.65ng/ml、0.65-1.29ng/ml、1.3-6.25ng/ml 和>6.25ng/ml；四组年龄：≤30 岁、31-35 岁、36-40 岁和>40 岁。
主要结果和机会的作用
共纳入 1410 对平均年龄为 35.2±6.4 岁、AMH 为 2.7±2.6ng/ml 的夫妇。在多变量逻辑回归分析中，控制年龄因素，在所有 AMH<0.65ng/ml 的患者中，至少有一个胚胎进行活检/刺激周期的机会[调整后的优势比（AdjOR）0.18[0.11-0.31]，p=0.008]、至少有一个整倍体胚胎进行活检/刺激周期的机会[AdjOR 0.18 [0.11-0.29]，p<0.001]以及进行活检后至少有一个整倍体胚胎的机会[AdjOR 0.34 [0.19-0.61]，p=0.015]均受到影响，以及在 AMH 为 0.65-1.29ng/ml 的患者中（AdjOR 0.52 [0.32-0.84]，p<0.001）、（AdjOR 0.49 [0.33-0.72]，p<0.001）和（AdjOR 0.57 [0.36-0.90]，p<0.001），分别。在多变量线性回归分析中，AMH 值并不影响胚胎质量（-0.72 [-1.03 至-0.41]，p<0.001）。
结论
无论年龄大小，卵巢储备功能降低（AMH<1.3ng/ml）的患者进行卵母细胞活检的机会较低，每个卵巢刺激周期获得至少一个整倍体胚胎的机会也较低。AMH 值不影响胚胎质量。
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