AMH水平对波塞冬3组患者IVF/ICSI-ET助孕结局的早期预测价值  

Early predictive value of AMH level for IVF/ICSI-ET outcomes in POSEIDON group 3

作　　者：唐志霞[1] 李娟 何晶晶 张影 宣恒华 洪名云[1] Tang Zhixia;Li Juan;He Jingjing;Zhang Ying;Xuan Henghua;Hong Mingyun(Reproductive Center,Hefei Maternal and Child Health Hospital/Anhui Women and Children's Medical Center/Maternal and Child Medical Center of Anhui Medical University,Hefei Anhui 230001,P.R.China)

机构地区：[1]合肥市妇幼保健院/安徽省妇女儿童医学中心/安徽医科大学妇幼医学中心生殖中心,安徽合肥230001

出　　处：《中国计划生育和妇产科》2025年第2期103-107,共5页Chinese Journal of Family Planning & Gynecotokology

基　　金：2022年度安徽省高校自然科学研究项目(项目编号:2022AH050785);合肥市2022年度第三批市关键共性技术研发项目(项目编号:GJ2022SM09);合肥市第七周期医学重点学科建设专科(项目编号:合卫医秘[2023]72号)。

摘　　要：目的探讨抗苗勒管激素(AMH)水平对波塞冬3组患者体外受精/卵泡质内单精子注射-胚胎移植(in vitro fertilization/intracytoplasmic sperm injection-embryo transfer,IVF/ICSI-ET)助孕结局的早期预测价值。方法收集合肥市妇幼保健院2021年3月至2024年1月行IVF/ICSI-ET助孕的波塞冬3组不孕症患者共计226个周期的相关资料。Logistic回归分析探讨影响波塞冬3组患者的IVF/ICSI-ET助孕结局的相关因素,受试者工作特征(receiver operating characteristic,ROC)曲线计算AMH预测IVF/ICSI-ET助孕结局的最佳截断值。根据AMH截断值分为两组:A组(AMH≤0.31 ng/mL)61个周期,B组(AMH>0.31 ng/mL)165个周期,比较两组妊娠结局。结果Logistic单因素回归分析发现AFC、基础FSH和AMH是影响波塞冬3组患者IVF/ICSIET助孕结局的危险因素(P<0.05);Logistic多因素回归分析发现,AMH是波塞冬3组不孕症患者IVF/ICSIET助孕结局的独立影响因素(P<0.05)。AMH预测波塞冬3组IVF/ICSI-ET助孕结局的曲线下面积(AUC)为0.704,最佳截断值为0.31 ng/mL,灵敏度83.50%、特异度51.50%。A组周期取消率、优质胚胎率高于B组,差异有统计学意义(P<0.05)。A组移植胚胎数、临床妊娠率低于B组,着床率高于B组,但差异无统计学意义(P>0.05)。结论血清AMH水平对波塞冬3组不孕症患者早期预测IVF/ICSI-ET助孕结局有一定的临床意义,AMH水平降低并不影响胚胎质量以及后期胚胎移植的妊娠结局。Objective To investigate the early predictive value of AMH level on in vitro fertilization/intracytoplasmic sperm injection-embryo transfer(IVF/ICSI-ET)outcome in POSEIDON group 3.Methods A total of 226 cycles of POSEIDON group 3 who underwent IVF/ICSI-ET assisted reproduction at Hefei Maternal and Child Health Hospital from March 2021 to January 2024 were collected.Logistic regression analysis was used to analyze the associated factors affecting the IVF/ICSI-ET outcomes in POSEIDON group 3,the receiver operating characteristic curve(ROC)was used to analyze and calculate the optimal cut-off value of AMH,and then divided into two groups according to the cut-off value of AMH:group A(AMH≤0.31 ng/mL,61 cycles)and group B(AMH>0.31 ng/mL,165 cycles)based on the best cutoff value of AMH for predicting IVF/ICSI-ET outcome.The outcomes of the two groups were compared.Results Univariate logistic regression analysis found that AFC,basic FSH and AMH were risk factors for predicting IVF/ICSI-ET outcome in POSEIDON group 3(P<0.05);multivariate logistic regression analysis found that AMH was an independent factor for the outcome of IVF/ICSI-ET in POSEIDON group 3(P<0.05).The area under the receiver-operating characteristic curve(ROC)of AMH for predicting IVF/ICSI-ET outcome was 0.704,and the best cutoff value was 0.31 ng/mL,with IVF/ICSI-ET outcome sensitivity of 83.50%and specificity of 51.50%.The rate of cycle cancellation and quality embryo in group A was significantly higher than those in group B,and the difference was statistically significant(P<0.05).The number of embryo transfer and clinical pregnancy rate in group A were lower than those of group B,while the implantation rate in group A was higher than that of in group B,but the difference was not statistically significant(P>0.05).Conclusion The serum AMH level has certain clinical significance for the early prediction of IVF/ICSI-ET outcome in POSEIDON group 3,reduced AMH levels did not affect embryo quality as well as pregnancy outcome in later embryo transfer.

关 键 词：抗苗勒管激素 波塞冬标准 妊娠结局 体外受精 胚胎移植 

分 类 号：R711.6[医药卫生—妇产科学]