抗缪勒氏管激素作为体外受精治疗中获得卵母细胞数量的预测因子。

IF 1.8 Q3 OBSTETRICS & GYNECOLOGY
Ana Braga Reis, Carla Leal, Márcia Barreiro, António Tomé, Emídio Vale-Fernandes
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引用次数: 0

摘要

目的评估血清抗缪勒氏管激素(AMH)与体外受精治疗控制性卵巢刺激后取回的卵母细胞数量之间的相关性,并确定预测刺激反应差和反应快的临界值:这是一项回顾性观察研究,包括2017年2月至2023年12月期间在一家医疗辅助生育中心进行的1003个周期的控制性卵巢刺激。排除标准如下:卵巢刺激开始前6个月以上获得的血清AMH水平、存在单卵巢、非白种人、为捐献卵母细胞或保存生育能力而进行的控制性卵巢刺激周期、有记录的子宫内膜异位症诊断、有记录的卵巢手术史以及病历中缺乏研究的基本数据(缺乏获得的卵母细胞数量或AMH值)。对促排卵反应差的定义是取卵数少于 3 个卵母细胞,反应大的定义是取卵数大于 15 个卵母细胞。使用斯皮尔曼相关性检验计算变量之间的相关性,并使用ROC(Receiver Operating Characteristic)曲线确定临界值:结果:AMH 与取卵数呈明显正相关(斯皮尔曼相关系数 = 0.60,p):事实证明,血清 AMH 可以很好地预测卵巢对体外受精治疗的控制性卵巢刺激的反应,这有助于支持临床决策。然而,它不应被用作卵巢反应差或高的绝对判别指标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Anti-Müllerian hormone as a predictor of the number of oocytes obtained during in vitro fertilization treatments.

Objective: To evaluate the correlation between serum anti-Müllerian hormone (AMH) and the number of oocytes retrieved after controlled ovarian stimulation for in vitro fertilization treatments and determine cut-off values predictive of poor and high response to stimulation.

Methods: It was performed a retrospective observational study that included 1003 cycles of controlled ovarian stimulation carried between February 2017 and December 2023 at a Medically Assisted Procreation Centre. The exclusion criteria were the following: serum AMH levels obtained more than 6 months prior to the start of the ovarian stimulation, the presence of a single ovary, non-Caucasian ethnicity, a controlled ovarian stimulation cycle performed for the purpose of oocyte donation or fertility preservation, a documented diagnosis of endometriosis, a documented history of ovarian surgery and the absence of essential data for the study in the medical records (absence of the number of oocytes obtained or the AMH value). Poor response to stimulation was defined as ≤ 3 oocytes retrieved, and high response was defined as > 15 oocytes. The correlation between variables was calculated using Spearman's correlation test and cut-off values were determined using ROC (Receiver Operating Characteristic) curves.

Results: AMH exhibited a significantly positive correlation with the number of oocytes retrieved (Spearman's correlation coefficient = 0.60, p<0.01). The predictive cut-off for poor ovarian response was 0.72 ng/mL (specificity of 95.13%, sensitivity of 43.23%), and the predictive cut-off for high ovarian response was 4.77 ng/mL (specificity of 89.86%, sensitivity of 38.22%).

Conclusions: Serum AMH proved to be a good predictor of the ovarian response to controlled ovarian stimulation for in vitro fertilization treatments, which makes it useful in supporting clinical decision-making. However, it should not be used as an absolute discriminator of poor or high ovarian response.

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来源期刊
CiteScore
3.30
自引率
6.70%
发文量
56
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