不同卵巢反应性患者血清及卵泡液AMH与IVF结局的相关性分析  

Correlation between serum and follicular fluid AMH and IVF outcome in patients with different ovarian response

作　　者：何艺磊[1] 李蓉[1] He Yilei;Li Rong(Reproductive Medical Center,Department of Obstetrics and Gynecology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院妇产科生殖医学中心,北京100191

出　　处：《中华生殖与避孕杂志》2023年第1期42-49,共8页Chinese Journal of Reproduction and Contraception

摘　　要：目的探讨不同卵巢反应性患者血清及卵泡液抗苗勒管激素(anti-Müllerian hormone,AMH)水平与单次促排卵周期优质胚胎数、新鲜周期移植妊娠结局及累积妊娠结局的相关性。方法采用回顾性队列研究的方法,首先选择2017年10月至2018年1月期间在北京大学第三医院妇产科生殖医学中心行体外受精/卵胞质内单精子注射和胚胎移植(in vitro fertilization/intracytoplasmic sperm injection and embryo transfer,IVF/ICSI-ET)的患者为研究对象,共714例,收集临床资料并对取卵日卵泡液进行AMH水平检测,根据卵巢反应分为卵巢正常反应组401例,卵巢低反应组124例,卵巢高反应组189例,比较3组患者的一般临床特征、基础血清AMH及取卵日卵泡液AMH水平、优质胚胎数、新鲜周期移植妊娠及活产率、累积妊娠及累积活产率等相关指标,并进行IVF结局的相关影响因素分析。结果卵巢低反应组、卵巢正常反应组和卵巢高反应组患者基础血清AMH及卵泡液AMH分别为(0.71±0.77)μg/L、(2.72±3.02)μg/L、(5.90±4.42)μg/L以及(3.31±3.37)μg/L、(4.43±5.03)μg/L、(6.20±5.37)μg/L,差异均具有统计学意义(均P<0.001)。卵巢低反应组与卵巢正常反应组单个促排卵周期累积妊娠率及活产率分别为21.31%(13/61)、41.18%(140/340)以及16.39%(10/61)、36.76%(125/340),差异均具有统计学意义(均P<0.001),而卵巢高反应与正常反应组差异均无统计学意义(均P>0.05)。年龄与血清AMH(P=0.045、P=0.017)、年龄与卵泡液AMH(P<0.001、P=0.026)对卵巢正常反应组优质胚胎数的影响具有统计学意义。卵泡液AMH水平为卵巢正常反应组新鲜周期移植妊娠率及累积妊娠率的影响因素(P=0.009、P=0.047)。以累积妊娠为标准计算卵泡液AMH cut-off值为3.50μg/L。结论年龄与血清AMH、卵泡液AMH为卵巢正常反应组优质胚胎数的影响因素。卵泡液AMH为卵巢正常反应组新鲜周期及累积妊娠率的影响因素。Objective To investigate the correlation between the levels of anti-Müllerian hormone(AMH)in serum and follicular fluid and the number of high-quality embryos in a single ovulation cycle,the pregnancy outcome of fresh cycle transplantation and cumulative pregnancy outcome in patients with different ovarian response.Methods Totally 714 patients who underwent in vitro fertilization/intracytoplasmic sperm injection and embryo transfer(IVF/ICSI-ET)in the Reproductive Medical Center,Department of Obstetrics and Gynecology of Peking University Third Hospital from October 2017 to January 2018 were retrospectively analyzed.Clinical data and follicular fluid on the day of oocyte collection were collected for AMH detection.According to the ovarian response,they were divided into three groups:401 cases in the normal ovarian response group,124 cases in the low ovarian response group and 189 cases in the high ovarian response group.The general clinical characteristics,basic serum AMH and follicular fluid AMH level on the day of oocyte collection,the number of high-quality embryos,pregnancy rate and live birth rate of fresh cycle transfer,cumulative pregnancy rate and cumulative live birth rate were compared,and the related influencing factors of IVF outcome were analyzed.Results The basic serum AMH and follicular fluid AMH of the low ovarian response group,the normal ovarian response group and the high ovarian response group were(0.71±0.77)μg/L,(2.72±3.02)μg/L,(5.90±4.42)μg/L and(3.31±3.37)μg/L,(4.43±5.03)μg/L,(6.20±5.37)μg/L,respectively,the differences were statistically significant(all P<0.001).The cumulative pregnancy rate and the cumulative live birth rate of a single ovulation cycle in the low ovarian response group and the normal ovarian response group were 21.31%(13/61),41.18%(140/340)and 16.39%(10/61),36.76%(125/340),respectively,with statistical significances(all P<0.001),while the differences between the high ovarian response group and the normal response group were not statistically significant(all P>

关 键 词：妊娠率 抗苗勒管激素 卵泡液 受精 体外 胚胎移植 

分 类 号：R714.8[医药卫生—妇产科学]