Research question

This study explored the relationship between anti-Müllerian hormone (AMH) and oocyte survival after vitrification. The association between AMH and blastocyst formation after oocyte vitrification was also assessed.

Design

A retrospective observational analysis was performed in a private IVF centre. A total of 4507 metaphase-II warmed oocytes were included from 450 couples, predominantly of Arab ethnicity. Between August 2015 and August 2018, couples underwent 484 intracytoplasmic sperm injection (ICSI) treatments using vitrified-warmed oocytes.

Results

Patients’ median age ± SD was 36.2 ± 6.1 years, AMH concentration 2.6 ± 3.4 ng/ml and body mass index (BMI) 26.5 ± 4.6 kg/m². The oocyte survival rate after vitrification was 87.37 ± 20.42%. AMH concentration showed a significant correlation (Kendall’s tau 0.087, P = 0.0079) with oocyte survival rate independent of oocyte yield. Correlation was significant (odds ratio 1.041, 95% confidence interval 1.007–1.077, P = 0.018) when a multivariant model was applied that included AMH, age and BMI. The receiver operating characteristic curve showed an AMH cut-off value of 1.09 ng/ml that could obtain at least a 70% survival rate, with an area under the curve of 0.669. Regarding embryo development in ICSI cycles including fresh and warmed oocytes for the same patient, blastocyst formation rate was higher in fresh compared with warmed oocytes (P < 0.001). In this subgroup no significant correlation was seen between fertilization or blastocyst rate and AMH concentration.

Conclusions

AMH concentration showed a significant correlation with oocyte survival. Blastocyst formation was significantly lower after oocyte vitrification, but no correlation was found with AMH. Clinicians should carefully evaluate oocyte vitrification for patients with AMH below 1.09 ng/ml and consider embryo accumulation for these patients in preference to oocyte accumulation.

中文翻译：

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抗苗勒管激素是玻璃化后卵母细胞存活的独立标志物。

研究问题

这项研究探讨了抗苗勒氏管激素（AMH）与玻璃化后卵母细胞存活之间的关系。还评估了AMH与卵母细胞玻璃化后胚泡形成之间的关系。

设计

在私人试管婴儿中心进行回顾性观察分析。来自450对夫妇的总共4507个中期-II期加热的卵母细胞，主要是阿拉伯人。在2015年8月至2018年8月之间，夫妇使用玻璃化温育的卵母细胞进行了484次胞浆内精子注射（ICSI）治疗。

结果

患者的中位年龄±SD为36.2±6.1岁，AMH浓度为2.6±3.4 ng / ml，体重指数（BMI）为26.5±4.6 kg / m ²。玻璃化后的卵母细胞存活率为87.37±20.42％。AMH浓度显示出与卵母细胞存活率显着相关（Kendall's tau 0.087，P = 0.0079），而与卵母细胞产量无关。相关性显着（比值1.041，95％置信区间1.007–1.077，P= 0.018），则应用包含AMH，年龄和BMI的多变量模型。接收器工作特性曲线显示AMH截止值为1.09 ng / ml，可以达到至少70％的存活率，曲线下面积为0.669。关于同一患者包括新鲜和温暖卵母细胞在内的ICSI周期的胚胎发育，新鲜胚胎的胚泡形成率高于温暖卵母细胞（P <0.001）。在该亚组中，未发现受精或胚泡率与AMH浓度之间存在显着相关性。

结论

AMH浓度显示与卵母细胞存活率显着相关。卵母细胞玻璃化后，胚泡的形成明显降低，但与AMH没有相关性。临床医生应仔细评估AMH值低于1.09 ng / ml的患者的卵母细胞玻璃化，并优先考虑这些患者的卵母细胞积累而不是卵母细胞积累。