Lin Pin-Yao, Huang Fu-Jen, Kung Fu-Tsai, Chiang Hsin-Ju, Lin Yu-Ju, Lin Yi-Chi, Lan Kuo-Chung
Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine Kaohsiung, 123 Ta-Pei Road, Niaosung Dist, Kaohsiung, Taiwan.
Int J Clin Exp Pathol. 2014 Aug 15;7(9):6245-53. eCollection 2014.
To determine whether or not the level of serum anti-Müllerian hormone (AMH) is related to early ovarian aging in young women (< 35 years of age) undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles.
Retrospective cohort study.
An IVF laboratory in a university hospital in Taiwan. Patient (s): 70 young women (< 35 years of age) with low level of serum AMH (< 2 ng/ml) and 104 young women with level of serum AMH (≥ 2 ng/ml) who underwent IVF/ICSI cycles between January 2011 and November 2012 were enrolled. Intervention (s): None. Main outcome measure (s): Number of oocytes, fertilization rate, embryo quality, cycle cancellation rate, clinical pregnancy/abortion rate, and perinatal/infant outcomes.
The clinical pregnancy rate per transfer was favorable (low AMH group vs. normal AMH group [47.2% and 47.9%]) for women < 35 years of age, including women with a low serum AMH. Similarly, the live birth rate per transfer (low AMH group vs. normal AMH group [37.7% and 35.4%]) and perinatal outcomes were also comparable between the two groups. A significantly higher cycle cancellation was noted in the low AMH group than the normal AMH group (24.2% vs. 7.6%).
Although early ovarian aging should be taken into consideration for young and infertile women with low AMH level than expected, our results suggest that low serum AMH level may suggest early ovarian aging in accelerated oocyte loss only, but may not fully represent "early ovarian aging" based on the favorable outcomes of pregnancy.
确定血清抗苗勒管激素(AMH)水平是否与接受体外受精(IVF)/卵胞浆内单精子注射(ICSI)周期的年轻女性(<35岁)的早期卵巢衰老有关。
回顾性队列研究。
台湾一所大学医院的体外受精实验室。患者:纳入了2011年1月至2012年11月期间接受IVF/ICSI周期的70名血清AMH水平低(<2 ng/ml)的年轻女性(<35岁)和104名血清AMH水平(≥2 ng/ml)的年轻女性。干预措施:无。主要观察指标:卵母细胞数量、受精率、胚胎质量、周期取消率、临床妊娠/流产率以及围产期/婴儿结局。
对于<35岁的女性,包括血清AMH水平低的女性,每次移植的临床妊娠率良好(低AMH组与正常AMH组分别为47.2%和47.9%)。同样,两组之间每次移植的活产率(低AMH组与正常AMH组分别为37.7%和35.4%)和围产期结局也相当。低AMH组的周期取消率显著高于正常AMH组(24.2%对7.6%)。
虽然对于AMH水平低于预期的年轻不孕女性应考虑早期卵巢衰老,但我们的结果表明,血清AMH水平低可能仅提示卵母细胞加速丢失导致的早期卵巢衰老,但基于良好的妊娠结局,可能不能完全代表“早期卵巢衰老”。