Specific ranges of anti-Mullerian hormone and antral follicle count correlate to provide a prognostic indicator for IVF outcome
Specific ranges of anti-Mullerian hormone and antral follicle count correlate to provide a prognostic indicator for IVF outcome
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DOI：
10.1016/j.repbio.2016.12.002
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发表时间：
2017-03-01
影响因子：
2.1
通讯作者：
Yovich, John
中科院分区：
文献类型：
--
作者：
Keane, Kevin;Cruzat, Vincius Fernandes;Yovich, John
高龄女性与卵巢储备（OR）减少相关，是限制辅助生殖技术（ART）成功率的主要因素。目前，预测卵巢对促性腺激素刺激的反应是通过经阴道超声测量窦卵泡计数（AFC）（OR 的间接测量）来确定的。然而，评估抗苗勒氏管激素 (AMH) 水平最近被证明与 OR 相关，并且其应用已被广泛采用。这项回顾性研究旨在确定接受 ART 的患者 AMH 和 AFC 的新范围之间的关系。 AMH 和 AFC 类别之间呈正相关（r=0.458，P < 0.01），特定 AFC 范围和平均血清 AMH 水平的线性一致性为 87%。两个 OR 标记均与女性年龄呈负相关（分别为 r =-0.428 和 r=-0.392）。妊娠率和活产率同时受到 AMH (P < 0.05) 和 AFC 类别 (P < 0.05) 的影响。相反，流产率似乎更依赖于 AFC 类别（P > 0.05），但更依赖于女性年龄。最后，收集的卵母细胞数量与AMH和AFC分级呈正相关，而卵母细胞和胚胎利用率则呈负相关。总体而言，两个 OR 标记彼此呈正相关且强烈相关，并且当个体 AMH 读数被分类到特定的新范围时，它们表现出与 AFC 分组更强大的相关性。总而言之，在特定范围内应用患者 AMH 可能会更好地估计 OR 和 IVF 结果。 (C) 2016 年由 Elsevier Sp. 出版。 z o.o.代表生殖生物学学会以及位于奥尔什丁的波兰科学院动物生殖和食品研究所。
Advanced female age correlates with reduced ovarian reserve (OR) and is the primary factor underlying the limitation of success rates in Assisted Reproductive Technology (ART). Currently, predicted ovarian response to gonadotrophin stimulation is determined using transvaginal ultrasound to measure antral follicle count (AFC), an indirect measure of OR. However, assessing the level of anti-Mullerian hormone (AMH) has more recently been shown to correlate with OR, and its application has been adopted widely. This retrospective study was designed to determine the relationship between novel ranges of AMH and AFC in patients undergoing ART. There was a positive correlation between AMH and AFC category (r=0.458, P < 0.01), with an 87% linear concordance observed for specific AFC ranges and mean serum AMH levels. Both OR markers were inversely correlated with female age (r =-0.428 and r=-0.392, respectively). Pregnancy and live birth rates were influenced by both AMH (P < 0.05) and AFC categories (P < 0.05). Conversely, miscarriage rates appeared to be more dependent on AFC categories (P >0.05), but even more reliant on female age. Finally, the number of oocytes collected was positively correlated with AMH and AFC grading, while oocyte and embryo utilization rates were negatively correlated. Overall, both OR markers were positively and strongly related with each other, and when individual AMH readings were categorised into specific novel ranges, they demonstrated a more robust correlation with AFC groupings. Taken together, applying patient AMH within specific ranges may lead to a better estimation of OR and IVF outcomes. (C) 2016 Published by Elsevier Sp. z o.o. on behalf of Society for Biology of Reproduction & the Institute of Animal Reproduction and Food Research of Polish Academy of Sciences in Olsztyn.