Carnesi Edoardo, Castellano Stefano, Albani Elena, Busnelli Andrea, Smeraldi Antonella, Bulbul Ozgur, Morenghi Emanuela, Immediata Valentina, Levi-Setti Paolo Emanuele
Division of Gynecology and Reproductive Medicine, Department of Gynecology, Fertility Center, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy.
Genomic Medicine Research Center, Department of Medicine and Surgery, University of Insubria, Varese, Italy.
Front Endocrinol (Lausanne). 2025 Jan 17;15:1535776. doi: 10.3389/fendo.2024.1535776. eCollection 2024.
Reproductive success shows a well-documented decline with advancing maternal age, primarily due to chromosomal abnormalities (aneuploidies) in embryos. While ovarian reserve markers such as Anti-Müllerian Hormone (AMH) and Antral Follicle Count (AFC) traditionally serve as quantitative predictors of fertility, emerging evidence suggests they may also reflect oocyte quality, particularly in patients with Diminished Ovarian Reserve (DOR). The relationship between these biomarkers and embryo chromosomal status remains complex and poorly understood.
We conducted a retrospective analysis of fertilization (IVF) cycles performed between 2015 and 2022, involving 773 female patients who underwent IVF and pre-implantation genetic screening for aneuploidy (PGT-A). Our patient cohort was divided into two groups: Group 1, consisting of women who achieved at least one euploid embryo, and Group 2, comprising women who did not.
The main outcome measures included the rate and number of euploid blastocysts and their correlation with ovarian reserve. Our results showed a statistically significant association between independent variables and embryo ploidy: AMH levels (OR 1.09; 95% CI 1.04-1.14, p<0.001), the age of the woman (OR 0.82; 95% CI 0.79-0.85, p<0.001), the number of oocytes retrieved (OR 1.050; 95% CI 1.01-1.08, p=0.05), and the fertilization rate (OR 6.69; 95% CI 2.67-16.77, p<0.001).
Our findings suggest that AMH levels are associated with embryo ploidy rate. These insights could enhance counseling practices in assisted reproductive technology (ART), offering patients a more detailed understanding of their infertility prognosis and the factors influencing IVF outcomes.
生殖成功率随母亲年龄增长而下降,这已被充分证明,主要原因是胚胎中的染色体异常(非整倍体)。虽然抗苗勒管激素(AMH)和窦卵泡计数(AFC)等卵巢储备指标传统上作为生育能力的定量预测指标,但新出现的证据表明它们也可能反映卵母细胞质量,特别是在卵巢储备功能减退(DOR)的患者中。这些生物标志物与胚胎染色体状态之间的关系仍然复杂且了解甚少。
我们对2015年至2022年间进行的773例接受体外受精(IVF)和非整倍体植入前基因筛查(PGT-A)的女性患者的受精周期进行了回顾性分析。我们的患者队列分为两组:第1组由至少获得一个整倍体胚胎的女性组成,第2组由未获得整倍体胚胎的女性组成。
主要结局指标包括整倍体囊胚的比率和数量及其与卵巢储备的相关性。我们的结果显示自变量与胚胎倍性之间存在统计学上的显著关联:AMH水平(OR 1.09;95%CI 1.04-1.14,p<0.001)、女性年龄(OR 0.82;95%CI 0.79-0.85,p<0.001)、取卵数量(OR 1.050;95%CI 1.01-1.08,p=0.05)和受精率(OR 6.69;95%CI 2.67-16.77,p<0.001)。
我们的研究结果表明AMH水平与胚胎倍性率相关。这些见解可以加强辅助生殖技术(ART)中的咨询实践,让患者更详细地了解其不孕预后以及影响IVF结果的因素。