Moreira Tânia, Leal Carla, Barreiro Márcia, Tomé António, Vale-Fernandes Emídio
ICBAS - School of Medicine and Biomedical Sciences, UMIB - Unit for Multidisciplinary Research in Biomedicine, University of Porto, Porto, Portugal.
Centro de Procriação Medicamente Assistida / Banco Público de Gâmetas, Centro Materno-Infantil do Norte Dr. Albino Aroso (CMIN), Centro Hospitalar Universitário de Santo António (CHUdSA), Unidade Local de Saúde de Santo António (ULSSA), Porto, Portugal.
JBRA Assist Reprod. 2025 Feb 21;29(2):201-10. doi: 10.5935/1518-0557.20240095.
Polycystic Ovary Syndrome (PCOS) is the most common endocrine disorder in women of reproductive age, being one of the main causes of infertility. Anti-Müllerian hormone (AMH) is an important marker of ovarian reserve and has been proposed as an alternative criterion for the diagnosis of PCOS. This study verifies whether AMH and body mass index (BMI) values are predictors of pregnancy in infertile women with PCOS undergoing artificial insemination (AI), a less invasive and painless technique of assisted reproductive technologies (ART).
This retrospective observational study involved 220 women with PCOS who underwent AI between 2010 and 2022. Participants were categorized into three groups based on BMI and serum AMH levels. To categorize the three AMH classes, the 25th (4.08ng/mL) and 75th (8.99ng/mL) AMH percentiles were defined as cut-offs, and the words 'low', 'middle', and 'high' were utilized to define the groups.
There was a tendency towards a decrease in reproductive outcomes (number of inseminations with positive human-chorionic gonadotropin, number of live births, and number of term births) with an increase in the BMI value. All of these outcomes were also slightly higher in women with 'middle' AMH levels compared to women with 'low' and 'high' AMH. However, none of these results were statistically significant.
This study suggests BMI may be an important predictive factor for pregnancy and there appears to be a range of biological normality for AMH values, where 'low' and 'high' levels of this hormone could constitute a marker of poor reproductive prognosis, in women with PCOS undergoing AI.
多囊卵巢综合征(PCOS)是育龄女性最常见的内分泌疾病,是不孕症的主要原因之一。抗苗勒管激素(AMH)是卵巢储备的重要标志物,已被提议作为PCOS诊断的替代标准。本研究验证了AMH和体重指数(BMI)值是否是接受人工授精(AI)的PCOS不孕女性妊娠的预测指标,人工授精是辅助生殖技术(ART)中一种侵入性较小且无痛的技术。
这项回顾性观察研究纳入了2010年至2022年间接受AI的220名PCOS女性。参与者根据BMI和血清AMH水平分为三组。为了对三个AMH类别进行分类,将第25百分位数(4.08ng/mL)和第75百分位数(8.99ng/mL)的AMH定义为临界值,并使用“低”、“中”和“高”来定义组。
随着BMI值的增加,生殖结局(人绒毛膜促性腺激素阳性的授精次数、活产次数和足月产次数)有下降趋势。与AMH水平“低”和“高”的女性相比,AMH水平“中”的女性所有这些结局也略高。然而,这些结果均无统计学意义。
本研究表明,BMI可能是PCOS不孕女性妊娠的重要预测因素,并且AMH值似乎存在一系列生物学正常范围,在接受AI的PCOS女性中,该激素的“低”水平和“高”水平可能构成生殖预后不良的标志物。