Lower antimüllerian hormone is associated with lower oocyte yield but not live-birth rate among women with obesity.
Lower antimüllerian hormone is associated with lower oocyte yield but not live-birth rate among women with obesity.
复制标题
DOI：
10.1016/j.ajog.2019.09.046
复制
发表时间：
2020-04
影响因子：
9.8
通讯作者：
Polotsky AJ
中科院分区：
文献类型：
--
作者：
Vitek W;Sun F;Baker VL;Styer AK;Christianson MS;Stern JE;Zhang H;Polotsky AJ
抗苗勒管激素由小的窦卵泡产生，反映卵巢储备。肥胖与血清抗苗勒管激素水平较低有关，但尚不清楚肥胖女性抗苗勒管激素水平较低是否反映卵巢储备能力较低。确定接受体外受精的肥胖妇女抗苗勒管激素水平降低是否与卵母细胞产量和活产率有关。回顾性队列研究来自辅助生殖技术临床结果报告系统数据库，包括2012年至2014年间首次自体体外受精的13316名肥胖女性和16579名BMI正常的女性。正常BMI定义为BMI 18.5 ~ 24.9 kg/m2，肥胖定义为BMI≥30 kg/m2，根据世界卫生组织BMI指南将肥胖患者分为1级肥胖（BMI 30.0 ~ 34.9 kg/m2）、2级肥胖（BMI 35.0 ~ 39.9 kg/m2）和3级肥胖（BMI≥40 kg/m2）。抗苗勒管激素水平分为正常（1.1 ng/ml）、低（0.16 ~ 1.1 ng/ml）和检测不到（≤0.16 ng/ml）。多变量模型采用对数变换线性回归评估卵母细胞产量，采用逻辑回归评估活产几率。肥胖妇女年龄较大（36.0±4.8比35.5±4.8，P<0.001），抗苗勒管激素水平较低（1.8±2.0 ng/ml比2.1±2.0 ng/ml， P<0.001），获得的卵母细胞较少（11.9±7.3比12.8±7.7，P<0.001）。与BMI和抗苗勒管激素水平正常的女性相比，肥胖且抗苗勒管激素水平正常的女性的卵母细胞产量较低（13.6±7.3比15.8±8.1，P<0.001）。与BMI正常且抗苗勒管激素水平相似的女性相比，肥胖且抗苗勒管激素水平低（P=0.58）和检测不到抗苗勒管激素（P=0.11）的女性的卵母细胞产量没有差异。在BMI≥30 kg/m2的女性中，抗苗勒管激素水平与获得的卵母细胞数量相关（β=0.069， SE=0.005, p<0.001），但与活产率无关（OR 0.98, 95% CI 0.93-1.04, p=0.57）。肥胖的不孕妇女抗苗勒管激素水平较低似乎反映了卵巢储备能力较低，因为抗苗勒管激素与卵母细胞产量较低有关。尽管卵母细胞产量较低，但抗苗勒管激素水平较低与肥胖妇女的低活产率无关。
Anti-Mullerian hormone is produced by small antral follicles and reflects ovarian reserve. Obesity is associated with lower serum anti-Mullerian hormone but it is unclear whether lower levels of anti-Mullerian hormone in women with obesity reflects lower ovarian reserve. To determine whether lower Anti-Mullerian hormone in women with obesity undergoing in vitro fertilization is associated with oocyte yield and live-birth rate. Retrospective cohort from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System database of 13316 women with obesity and 16579 women with normal BMI undergoing their first autologous IVF with fresh transfers between 2012 and 2014. Normal BMI was defined as BMI 18.5–24.9 kg/m2, obesity was defined as BMI ≥30 kg/m2 and subjects with obesity were stratified as Class 1 obesity (BMI 30.0–34.9 kg/m2), Class 2 obesity (BMI 35.0–39.9 kg/m2) and Class 3 obesity (BMI ≥40 kg/m2) based on the World Health Organization BMI guidelines. Anti-Mullerian hormone levels were stratified as normal (>1.1 ng/ml), low (0.16–1.1 ng/ml) and undetectable (≤ 0.16 ng/ml). Multivariable modeling was used to assess oocyte yield using linear regression with a logarithmic transformation and odds of live birth using logistic regression. Women with obesity were older (36.0 ± 4.8 vs. 35.5 ± 4.8, P<0.001), had lower Anti-Mullerian hormone (1.8 ± 2.0 ng/ml vs. 2.1 ± 2.0 ng/ml, P<0.001) and fewer oocytes retrieved (11.9 ± 7.3 vs. 12.8 ± 7.7, P<0.001) than women with normal BMI. Lower oocyte yield was observed among women with obesity and normal Anti-Mullerian hormone levels compared to women with normal BMI and normal Anti-Mullerian hormone levels (13.6 ± 7.3 vs. 15.8 ± 8.1, P<0.001). No difference in oocyte yield was observed among women with obesity and low Anti-Mullerian hormone levels (P=0.58) and undetectable Anti-Mullerian hormone (P=0.11) compared to women with normal BMI and similar Anti-Mullerian hormone levels. Among women with a BMI ≥30 kg/m2, Anti-Mullerian hormone levels were associated with the number of oocytes retrieved (β=0.069, SE=0.005, p<0.001) but not live birth rates (OR 0.98, 95% CI 0.93–1.04, p=0.57). Lower Anti-Mullerian hormone in infertile women with obesity appears to reflect lower ovarian reserve as Anti-Mullerian hormone is associated with lower oocyte yield. Despite lower oocyte yield, lower Anti-Mullerian hormone was not associated with lower live birth rate among women with obesity.
登录
查看更多内容
影响因子：
6.7
作者：
通讯作者：
--
DOI：
10.1152/ajpendo.90684.2008
发表时间：
2009-02-01
影响因子：
5.1
作者：
Piouka, Athanasia;Farmakiotis, Dimitrios;Panidis, Dimitrios
通讯作者：
Panidis, Dimitrios
影响因子：
2.6
作者：
Sahmay, Sezai;Usta, Taner;Seyisoglu, Hakan
通讯作者：
Seyisoglu, Hakan
影响因子：
6.7
作者：
Seifer, David B.;Tal, Oded;Baker, Valerie L.
通讯作者：
Baker, Valerie L.
影响因子：
5
作者：
Sutton-Tyrrell, Kim;Zhao, Xinhua;Matthews, Karen
通讯作者：
Matthews, Karen