IVF-ET中抗缪勒管激素低下患者微刺激方案的临床结局分析

Clinical Outcome of Low AMH Patients Undergoing Mild Ovarian Stimulation in IVF-ET

目的探讨IVF-ET中抗缪勒管激素AMH低下患者微刺激方案的临床结局。方法回顾性分析2016年5—10月47例AMH<1.0ng·mL^(-1)行微刺激方案促排卵的不孕患者,将AMH<0.3ng·mL^(-1)者归为A组,0.3≤AMH<1.0ng·mL^(-1)者归为B组。比较2组一般情况及促排结局。结果 A组窦卵泡计数(AFC)少于B组(P<0.05)。2组促性腺激素(Gn)天数、Gn总量、停药日黄体生成素、停药日孕酮、停药日内膜、受精率、优胚数、优胚率比较差异无统计学意义(P>0.05)。A组停药日雌二醇、获卵数、受精卵数少于B组(P<0.05)。结论 AMH<0.3ng·mL^(-1)患者优胚数与0.3≤AMH<1.0ng·mL^(-1)患者类似。故AMH<0.3ng·mL^(-1)不宜作为拒绝患者接受助孕治疗的临界值。

Objective To investigate the clinical outcome of low anti-Müllerian hormone(AMH)patients undergoing mild ovarian stimulation in in-vitro fertilization and embryo transfer(IVF-ET).Methods Data of 47 infertile patients with AMH <1.0ng·mL^(-1) who underwent mild ovary stimulation from May 2016 to October 2016 were analyzed retrospectively.According to AMH levels,these patients were divided into group A(AMH<0.3ng·mL^(-1))and group B(0.3≤AMH<1.0ng·mL^(-1)).General condition and ovarian hyperstimulation outcome were compared between the two groups.Results The antral follicle count,HCG day E2 level,number of oocytes retrieved and number of fertilized oocytes in group A were significantly lower than those in group B(P<0.05).There were no significant differences between the two groups in gonadotropin administration duration,total gonadotropin dosage,HCG day luteinizing hormone level,HCG day progesterone level,HCG day endometrial thickness,fertilization rate,and number and rate of high quality embryos(P>0.05).Conclusion Patients with AMH<0.3ng·mL^(-1) have similar number of high quality embryos to patients with 0.3≤AMH<1.0ng·mL^(-1).Therefore,AMH<0.3ng·mL^(-1) should not be used as the cutoff value for rejecting patients to receive assisted reproduction.