血清AMH值与高龄冻融胚胎移植患者临床妊娠率的相关性研究

Correlation analysis of baseline antimullerian hormone level and clinical pregnancy rate in advanced age patients with frozen-thawed embryo transfer

目的探讨血清抗缪勒管激素(AMH)与高龄(≥40岁)冻融胚胎移植患者临床结局的相关性。方法选取进行第一次冻融胚胎移植的高龄(≥40岁)不孕患者的相关资料进行回顾性分析,根据患者的血清AMH值分为A组(AMH<1.1 ng/mL,n=37)和B组(AMH≥1.1 ng/mL,n=63);根据妊娠结局分为妊娠组(n=14)和非妊娠组(n=86)。分析比较血清AMH值与冻融胚胎移植临床妊娠率的关系。结果A、B两组患者的年龄分别为(43.86±3.19)岁、(42.03±2.17)岁,A组患者年龄明显大于B组(P<0.05);妊娠组与非妊娠组患者年龄分别为(41.93±2.34)岁、(42.94±2.81)岁,前一组的年龄小于后一组(P<0.05);妊娠组、非妊娠组患者的血清AMH值分别为(3.26±2.90)ng/mL、(2.01±1.77)ng/mL,妊娠组明显高于非妊娠组(P<0.05)。对妊娠结局进一步采用logistic回归单因素分析发现,年龄(OR=0.693,95%CI:0.493~0.974,P<0.05)和AMH水平(OR=1.417,95%CI:1.089~1.843,P<0.05)对临床妊娠率有明显影响;多因素分析发现,年龄和AMH依旧是对临床妊娠率有明显影响的因素(OR=0.636,95%CI:0.414~0.9783,P<0.05)、(OR=1.493,95%CI:1.052~2.118,P<0.05)。结论在高龄患者中年龄相对越小其血清AMH水平越高,那么冻融胚胎移植的临床妊娠率就相对越高。

Objective To investigate the relationship between serum anti-Mullerian hormone(AMH)and pregnancy outcome in frozen-thawed embryo transfer patients with age≥40 years old.Methods The retrospective analysis was performed on the relevant process data of the elder infertile patients(≥40 years old)undergoing the first freeze-thawed embryo transfer in this center from June 2016 to October 2017.The subjects were divided into the group A(AMH<1.1 ng/mL,n=37)and group B(AMH≥1.1 ng/mL,n=63)according to the basic AMH level;these subjects were divided into the pregnancy group(n=14)and non-pregnancy group(n=86)according to the pregnancy outcomes.The relationship between serum AMH and pregnancy outcome of frozen-thawed embryo transfer was compared and analyzed.Results The ages of the group A and B were(43.86±3.19)years old and(42.03±2.17)years old.The age in the group A was elder than that in the group B(P<0.05).The ages of pregnancy group and non-pregnant group were(41.93±2.34)years old and(42.94±2.81)years old,the pregnant group was younger than the non-pregnant group(P<0.05);the serum AMH values of the pregnant and non-pregnant groups were(3.26±2.90)ng/mL and(2.01±1.77)ng/mL respectively,and the pregnancy group was significantly higher than the non-pregnant group(P<0.05).The logistic regression univariate analysis of pregnancy outcomes found that the age(OR=0.693,95%C I:0.493~0.974,P<0.05)and AMH level(OR=1.417,95%CI:1.089~1.843,P<0.05)had the significant effects on clinical pregnancy;in the multivariate analysis,the age and AMH level was still found having significant effect on clinical pregnancy(OR=0.636,95%CI:0.414~0.9783,P<0.05),(OR=1.493,95%CI:1.052~2.118,P<0.05).Conclusion The younger the age,the higher the basal serum AMH level the higher the pregnancy rate of frozen-thawed embryo transfer in elder patients.