Tang Shufang, Zhao Panpan, Sun Kaixuan, Zhang Qian, Yu Yuexin
Department of Reproductive Medicine, Postgraduate Training Base of Jinzhou Medical University (General Hospital of Northern Theater Command), No. 83, Wenhua Road, Shenhe District, Shenyang, 110016, China.
Department of Reproductive Medicine, General Hospital of Northern Theater Command, No. 83, Wenhua Road, Shenhe District, Shenyang, 110016, China.
J Assist Reprod Genet. 2025 Sep 4. doi: 10.1007/s10815-025-03619-x.
The association between anti-Müllerian hormone (AMH) levels and embryonic aneuploidy rates was investigated by analyzing clinical and embryo laboratory data from patients with preimplantation genetic testing for aneuploidy (PGT-A). However, the nonlinear relationship and threshold effect of AMH on aneuploidy risk remain poorly understood.
This retrospective study analyzed the clinical data of 819 PGT-A cycles performed between January 2018 and August 2024 at the General Hospital of Northern Theater Command. We used restricted cubic spline (RCS) to investigate the dose-response relationship between the AMH levels and aneuploidy rate, adjusting for potential confounders.
Significant differences were observed in normal fertilization rates, day 3 high-quality embryo rates, blastocyst formation rates, euploidy embryo rates, aneuploid embryo rates, and mosaic embryo rates among the three AMH groups (P < 0.05). A statistically significant nonlinear relationship between AMH levels and aneuploidy rate was identified (P < 0.05). RCS and threshold effect analyses revealed that the risk of a positive (≥ 50%) aneuploidy rate increased by 40% for each 1-unit decrease in AMH when AMH ≤ 2.54 ng/mL.
In the PGT-A population, advanced maternal age (AMA), recurrent spontaneous abortion (RSA), or recurrent implantation failure (RIF) have been identified as contributing factors. After adjusting for potential confounders such as female age, AMH remains a significant risk factor for embryonic aneuploidy rates. The findings suggested that lower AMH levels are associated with a higher risk of embryonic aneuploidy, indicating that ovarian reserve function may be correlated with oocyte quality. These results provide new insights for individualized decision-making in assisted reproduction. Trial registration ChiCTR2500099710 (03/27/2025).
通过分析接受胚胎植入前非整倍体基因检测（PGT-A）患者的临床和胚胎实验室数据，研究抗苗勒管激素（AMH）水平与胚胎非整倍体率之间的关联。然而，AMH对非整倍体风险的非线性关系和阈值效应仍知之甚少。
这项回顾性研究分析了2018年1月至2024年8月在北部战区总医院进行的819个PGT-A周期的临床数据。我们使用限制立方样条（RCS）来研究AMH水平与非整倍体率之间的剂量反应关系，并对潜在混杂因素进行校正。
在三个AMH组中，正常受精率、第3天优质胚胎率、囊胚形成率、整倍体胚胎率、非整倍体胚胎率和嵌合胚胎率存在显著差异（P<0.05）。确定了AMH水平与非整倍体率之间存在统计学显著的非线性关系（P<0.05）。RCS和阈值效应分析显示，当AMH≤2.54 ng/mL时，AMH每降低1个单位，非整倍体率为阳性（≥50%）的风险增加40%。
在PGT-A人群中，高龄产妇（AMA）、复发性自然流产（RSA）或复发性植入失败（RIF）已被确定为促成因素。在调整了女性年龄等潜在混杂因素后，AMH仍然是胚胎非整倍体率的一个重要风险因素。研究结果表明，较低的AMH水平与胚胎非整倍体风险较高相关，表明卵巢储备功能可能与卵母细胞质量相关。这些结果为辅助生殖中的个体化决策提供了新的见解。试验注册号ChiCTR2500099710（2025年3月27日）。
