Diminished ovarian reserve as measured by means of baseline follicle-stimulating hormone and antral follicle count is not associated with pregnancy loss in younger in vitro fertilization patients
Diminished ovarian reserve as measured by means of baseline follicle-stimulating hormone and antral follicle count is not associated with pregnancy loss in younger in vitro fertilization patients
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DOI：
10.1016/j.fertnstert.2017.09.011
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发表时间：
2017-12-01
影响因子：
6.7
通讯作者：
Devine, Kate
中科院分区：
文献类型：
--
作者：
Bishop, Lauren A.;Richter, Kevin S.;Devine, Kate
目的：评估大量通过体外受精 (IVF) 怀孕的女性中卵巢储备功能下降与妊娠结局之间的关系。我们评估了窦卵泡计数 (AFC) 和基线 FSH 作为卵巢储备的衡量标准。其次，我们评估了卵巢储备功能下降是否与自然流产中的非整倍性相关。设计：回顾性队列研究。设置：多中心私人诊所。患者：2009-2013 年期间接受新鲜自体 IVF 周期的所有 21-44 岁患者，结果血清 hCG 呈阳性，并记录基线 FSH 水平。干预措施：无。主要结果指标：每早产儿的活产数妊娠、生化妊娠、临床妊娠丢失以及妊娠丢失中受孕产物的非整倍体率。结果：对 8,214 名患者的总共 9,489 个周期进行了分析。 35 岁以下妊娠 IVF 患者的活产与卵巢储备之间没有关联。在 35 岁及以上的患者中，基线 FSH 升高与较高的流产风险相关，且流产风险随着年龄的增加而增加。在任何年龄，AFC 与流产均无显着相关性。在年龄调整分析中，没有发现卵巢储备功能与受孕产物非整倍性之间存在关联，尽管有效评估这一点的能力有限。 结论：卵巢储备功能下降与通过 IVF 怀孕的年轻女性流产率增加无关。 FSH 升高与老年患者 IVF 妊娠失败的风险较高相关。我们没有发现证据证实卵巢储备功能下降与自然流产中非整倍性增加有关。 （(C) 2017 年，美国生殖医学会。）
Objective: To assess the relationship between diminished ovarian reserve and pregnancy outcomes in a large cohort of women achieving pregnancy through in vitro fertilization (IVF). We evaluated antral follicle count (AFC) and baseline FSH as a measure of ovarian reserve. Secondarily, we assessed whether diminished ovarian reserve was associated with aneuploidy among spontaneous abortions.Design: Retrospective cohort study.Setting: Multicenter private practice.Patient(s): All patients aged 21-44 years undergoing fresh autologous IVF cycles during 2009-2013 that resulted in positive serum hCG with recorded baseline FSH levels.Intervention(s): None.Main Outcome Measure(s): Live births per early pregnancy, biochemical pregnancies, clinical pregnancy losses, and aneuploidy rates in products of conception among pregnancy losses.Result(s): A total of 9,489 cycles among 8,214 patients were analyzed. There was no association between live birth and ovarian reserve among pregnant IVF patients under the age of 35 years. Among patients 35 years of age and older, elevated baseline FSH was associated with a higher risk of pregnancy loss, which increased with increasing age. AFC was not significantly associated with pregnancy loss at any age. No associations were found between ovarian reserve measures and aneuploidy in products of conception in age-adjusted analyses, although the power to effectively evaluate this was limited.Conclusion(s): Diminished ovarian reserve is not associated with an increase in miscarriage among younger women achieving pregnancy through IVF. Elevated FSH is associated with a higher risk of IVF pregnancy loss among older patients. We found no evidence to confirm that diminished ovarian reserve is associated with increased aneuploidy among spontaneous abortions. ((C) 2017 by American Society for Reproductive Medicine.)