Purpose

To enhance the understanding of the clinical significance of anti-Müllerian hormone (AMH) in follicular fluid, we aimed to determine the variability of AMH concentrations in follicular fluid within and across IVF cycles and whether high follicular fluid AMH concentrations are associated with improved clinical IVF outcomes.

Methods

This was a retrospective cohort study of companion follicular fluid and serum samples from 162 women enrolled in the Environment and Reproductive Health (EARTH) Study between 2010 and 2016. AMH concentrations were quantified using a sandwich enzyme-linked immunosorbent assay. Spearman correlation and intra-class correlation (ICC) were calculated to assess variability of follicular fluid AMH, and generalized linear mixed models were used to evaluate the associations of FF AMH with IVF outcomes.

Results

The median (interquartile range, IQR) age of the 162 women was 34.0 years (32.0, 37.0). Follicular fluid AMH concentrations were highly correlated between follicles within each IVF cycle (Spearman r = 0.78 to 0.86) and across cycles for each woman (ICC 0.87 (95% CI 0.81 to 0.92)). Compared with women in the highest tertile of FF AMH (mean AMH = 2.3 ng/ml), women in the lowest tertile (mean AMH = 0.2 ng/ml) had lower serum AMH (T1 = 0.1 ng/ml vs. T3 = 0.6 ng/ml, p < 0.0001). In adjusted models, higher tertiles of follicular fluid AMH concentrations were associated with lower mean endometrial thickness and higher probability of clinical pregnancy.

Conclusions

Follicular fluid AMH concentrations show little variability between pre-ovulatory follicles, and higher pre-ovulatory follicular fluid AMH may predict a higher probability of clinical pregnancy.

中文翻译：

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生育中心女性新鲜胚胎移植体外受精周期的卵泡液抗苗勒氏管激素 (AMH) 浓度和结果

 目的

为了加深对卵泡液中抗苗勒氏管激素 (AMH) 临床意义的理解，我们旨在确定 IVF 周期内和跨 IVF 周期内卵泡液中 AMH 浓度的变异性，以及高卵泡液 AMH 浓度是否与改善临床 IVF 相关结果。

 方法

这是一项回顾性队列研究，研究对象为 2010 年至 2016 年间参加环境与生殖健康 (EARTH) 研究的 162 名女性的卵泡液和血清样本。使用夹心酶联免疫吸附测定法对 AMH 浓度进行定量。计算 Spearman 相关性和组内相关性 (ICC) 来评估卵泡液 AMH 的变异性，并使用广义线性混合模型来评估 FF AMH 与 IVF 结局的关联。

 结果

162 名女性的中位年龄（四分位距，IQR）为 34.0 岁（32.0，37.0）。卵泡液 AMH 浓度在每个 IVF 周期内的卵泡之间（Spearman r = 0.78 至 0.86）以及每位女性的周期间（ICC 0.87（95% CI 0.81 至 0.92））高度相关。与 FF AMH 最高三分位数（平均 AMH = 2.3 ng/ml）的女性相比，最低三分位数（平均 AMH = 0.2 ng/ml）的女性血清 AMH 较低（T1 = 0.1 ng/ml vs. T3 = 0.6）纳克/毫升， p < 0.0001）。在调整后的模型中，卵泡液 AMH 浓度较高的三分位数与较低的平均子宫内膜厚度和较高的临床妊娠概率相关。

 结论

卵泡液 AMH 浓度在排卵前卵泡之间几乎没有变化，较高的排卵前卵泡液 AMH 可能预示着较高的临床妊娠概率。