1. Predictive value of anti-Mullerian hormone for pregnancy outcomes following assisted reproductive techniques (ART) in Southwest China.
- Author
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Liu, Ling, Sun, Xing-Yu, Yang, Huan, Feng, Xin-Jian, and Lan, Yun-Zhu
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PREDICTIVE tests , *OVUM , *MISCARRIAGE , *RETROSPECTIVE studies , *PREGNANCY outcomes , *INFERTILITY , *GONADOTROPIN , *SEX hormones , *HUMAN reproductive technology , *PREDICTIVE validity , *FERTILIZATION in vitro , *ECTOPIC pregnancy , *RECEIVER operating characteristic curves , *STATISTICAL correlation , *LONGITUDINAL method , *MULTIPLE pregnancy - Abstract
Background: Anti-Müllerian hormone (AMH) is secreted by granulosa cells in preantral follicles and small antral follicles. There is limited information about whether serum AMH levels are related to pregnancy outcomes during in vitro fertilization and embryo transfer (IVF-ET). The aim of this study was to provide a theoretical basis for improving pregnancy outcomes. Methods: A retrospective cohort study was conducted on infertile women who were treated at the Reproductive Centre of the Affiliated Hospital of Southwest Medical University between September 2018 and September 2019. The sample included 518 participants from Southwest China. The participants were divided into 2 groups according to their AMH level. Their data were retrieved from the medical records: days and dosage of gonadotropin (Gn) (one bottle equals 75 IU), the number of oocytes obtained, the number of oocytes in metaphase II (MII) and the number of high-quality embryos. The pregnancy outcomes were followed up and divided into two groups according to whether they were pregnant or not, with statistical analysis of the parameters related to the in vitro fertilization process performed separately. Results: Compared to a lower AMH level (AMH ≤ 1.1), a higher AMH level (AMH > 1.1) resulted in less total Gn (bottle) (P = 0.00 < 0.05) and a lower starting Gn (IU) (P = 0.00 < 0.05), while the number of oocytes obtained,MII,cleavages and high-quality embryos were higher (P = 0.00 < 0.05). The participants' pregnancy outcomes (ectopic pregnancy, miscarriage, singleton, twin, multiple births) were found to not be predictable by AMH through ROC curves (P = 0.980, 0.093, 0.447, 0.146, 0.526, and 0.868 > 0.05). For participants in the pregnancy group, although AMH was lower in the nonpregnant participants(P = 0.868 > 0.05), the difference was not statistically significant, and the correlation coefficients between the two groups suggested no differences in the IVF process, except for the starting Gn (IU) (P = 0.038 < 0.05). Conclusion: AMH has clinical application value in predicting ovarian reserve function, providing guidance and suggestions for the specific formulation of ovulation promotion programs with assisted reproductive technology, but it cannot effectively predict the outcome of clinical pregnancy. Plain language summary: Compared with traditional parameters, including FSH, LH, E2, INH-B and AFC, for predicting outcomes of pregnancy during ART, AMH has good repeatability, strong stability and little fluctuation during different periods of the menstrual cycle, which has stronger clinical application value. However, there is limited information about whether serum AMH levels are related to pregnancy outcomes after in vitro fertilization and embryo transfer (IVF-ET). This research examined the ability of AMH levels to predict pregnancy outcomes following assisted reproductive techniques. A retrospective cohort study on 518 infertile women treated at the Affiliated Hospital of Southwest Medical University between September 2018 and September 2019 was conducted. The higher AMH (AMH > 1.1) group had less total Gn (bottle) (35 (25–44) vs. 42 (36–50.8), P = 0.00 < 0.05) and a lower starting Gn (IU) ((225 (150–300) vs. 300 (225–300), P = 0.00 < 0.05), while the numbers of oocytes obtained,the numbers of MII,the numbers of cleavages and the numbers of high-quality embryos were greater (P = 0.00 < 0.05).The participants' pregnancy outcome (ectopic pregnancy, miscarriage, singleton, twin, multiple births) could not be predicted by AMH as shown through ROC curves (P > 0.05). For participants in the pregnancy group, the difference in the starting Gn (IU) was statistically significant (IU) (225 (150–300) vs. 225 (187.5–300), P = 0.038 < 0.05). Although AMH was lower in the nonpregnant participants (3.630 (1.940–6.110) vs. 3.750 (1.960–5.885), P = 0.868 > 0.05), the difference was not statistically significant, and the correlation coefficients between the two groups suggested no difference in the IVF process. These findings suggest that AMH has clinical application value in predicting ovarian reserve function, providing guidance and suggestions for the specific IVF protocol, but it cannot effectively predict the outcome of clinical pregnancy. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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