抗苗勒管激素结合年龄预测体外受精-胚胎移植结局的价值

Predictive value of AMH combined with age for IVF-ET outcomes

目的分析体外受精-胚胎移植(IVF-ET)患者血清抗苗勒管激素(AMH)水平与年龄预测助孕结局的价值。方法酶联免疫吸附法(ELISA)检测3 086例就诊患者血清AMH水平,分析血清AMH水平与年龄的关系,同时分析其中768例(768个周期)不同年龄段行IVF-ET患者的血清AMH水平与获卵数、正常受精数(2PN数)、可用胚数、优质胚胎数、临床妊娠率之间的相关关系。结果 (1)血清AMH水平随年龄增长呈递减趋势;(2)在妊娠组与非妊娠组之间,血清AMH水平差异有统计学意义(χ~2=1.23,P<0.05);(3)在≥40岁高龄患者中,妊娠组与非妊娠组血清中AMH水平比较,差异无统计学意义(t=0.88,P>0.05);(4)h CG日雌二醇(E2)水平、获卵数、2PN数、可用胚数、优质胚胎数随血清AMH水平的升高而增加,均与血清AMH水平呈正相关,差异有统计学意义(r值分别为0.44、0.45、0.41、0.36、0.21,P<0.05)。结论 (1)AMH结合年龄对IVF-ET结局有较高的预测价值,血清AMH水平可以作为IVF-ET结局的预测因子。(2)当患者年龄≥40岁,血清AMH水平与其妊娠结局关系不明显。

Objective To analyze the predictive value of serum anti-mtillerian hormone （AMH） combined with age for in vitro fertili- zation and embryo transfer （IVF-ET） outcomes. Methods ELISA was used to detect the levels of AMH in 3 086 patients, the relationship between serum AMH levels and age was analyzed. A total of 768 patients （768 cycles） underwent IVF-ET in different age groups, the rela- tionships between serum AMH levels and the numbers of retrieved oocytes, normal fertilization （ 2PN ） , available embryos, high-quality em- bryos and clinical pregnancy rate were analyzed. Results Serum AMH levels showed a decreasing trend with age. There was statistically significant difference in serum AMH level between pregnancy group and non-pregnancy group （X2 = 1.23, P〈0. 05 ） . Among the patients aged 40 years old or more than 40 years old, there was no statistically significant difference in serum AMH level between pregnancy group and non-pregnancy group （t = 0. 88, P〉0. 05 ） . Estradiol level on the day of hCG injection, the numbers of retrieved oocytes, 2PN, available embryos and high-quality embryos increased with the level of serum AMH, there were positive correlations （ r=0.44, 0. 45, 0. 41, 0. 36, 0. 21, P〈 0. 05 ） . Conclusion The predictive value of AMH combined with age for IVF-ET outcomes is high, serum AMH can be used as a predictor of IVF-ET outcomes. Among the patients aged 40 years old or more than 40 years old, the relationship between serum AMH lev- els and pregnancy outcomes is not obvious.