基础抗苗勒管激素在卵泡期长效促性腺激素释放激素激动剂长方案中对卵巢反应性及妊娠结局的预测价值

摘要

Objective To explore the potential value of basal serum anti-Mülerian hormone (AMH) concentration in predicting ovarian response and pregnancy outcomes in follicular-phase long-acting gonadotropin releasing hormone (GnRH) agonist long protocol.Methods This study is an aggregated cohort study based on electronic medical records and a total number of 4 075 patients were recruited in this retrospective study.These patients were divided into three groups (low,normal and high response) according to the ovarian response and were divided into two groups (pregnancy and non-pregnancy) according to pregnancy outcomes.The logistic regression analysis and receiver operating characteristic curve (ROC) were used to compare the predictive value of AMH on ovarian response and pregnancy outcomes.Results Basal AMH was the most effective factor for predicting ovarian response.The area under the receiver operating characteristic curve (AUC) analysis of AMH for low and high ovarian response prediction was 0.853 and 0.764,respectively.The cut-off point of AMH for predicting low and high ovarian response is 1 μg/L and 2.75 μg/L,respectively.AMH has a low predictive value for clinical pregnancy outcomes.Conclusion Basal AMH is the most powerful predicting factor for ovarian response,especially for low ovarian response,but not a significant predicting factor for pregnancy outcomes.%目的 探讨在卵泡期长效促性腺激素释放激素(GnRH)激动剂长方案中,血清抗苗勒管激素(AMH)浓度对卵巢反应性、临床妊娠的预测价值.方法 本研究为基于电子医疗记录的聚合式队列研究,回顾性分析接受试管婴儿助孕治疗的4075名患者,根据卵巢反应性分为低反应、正常反应及高反应组,根据妊娠结局分为妊娠组和未妊娠组,采用logistic回归及受试者工作特征曲线(ROC)分析AMH对卵巢反应性及妊娠结局的预测价值.结果 AMH是卵巢反应性的有效预测因子,预测卵巢低反应、高反应的曲线下面积分别为0.853、0.764,临界值分别为1μg/L、2.75 μg/L,但对临床妊娠的预测价值较低.结论 AMH是卵巢反应性的有效独立预测因子,且对低反应的预测价值高于高反应,但不能有效预测临床妊娠结局.