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Maternal age affects the relationship of basal FSH and anti-Müllerian hormone concentrations with post-ICSI/IVF live birth
Reproductive BioMedicine Online ( IF 4 ) Pub Date : 2020-12-14 , DOI: 10.1016/j.rbmo.2020.12.005
Jose Buratini 1 , Mariabeatrice Dal Canto 2 , Elena De Ponti 3 , Fausta Brambillasca 2 , Claudio Brigante 2 , Silvana Gippone 2 , Mario Mignini Renzini 2 , Antonio La Marca 4
Affiliation  

Research question

Does the association of basal FSH and anti-Müllerian hormone (AMH) concentrations with post-IVF/intracytoplasmic sperm injection (ICSI) live birth change with maternal age?

Design

A total of 2003 IVF/ICSI patients were stratified according to basal FSH/AMH in concordant favourable (CF; AMH >1 ng/ml and FSH ≤10 IU/l), concordant unfavourable (CU; AMH ≤1 ng/ml and FSH >10 IU/l), discordant with favourable AMH (DFA) and discordant with favourable FSH (DFF) groups, as well as according to age in pre-advanced maternal age (pre-AMA; <35), AMA-1 (≥35, ≤37), AMA-2 (>37, ≤40) and AMA-3 (>40). IVF/ICSI outcomes were compared among CF, CU, DFA and DFF groups, and the association of basal FSH and AMH concentrations with live birth was tested by univariate and multivariate analysis in total, pre-AMA and AMA groups, separately.

Results

Different outcome patterns were observed in discordant AMH/FSH groups from different age categories; favourable basal FSH concentrations were associated with higher delivery rates in pre-AMA patients, but with lower delivery rates in AMA groups. Within pre-AMA patients, DFF patients presented higher delivery rates but lower oocyte yield compared with DFA patients. In the univariate analysis, favourable AMH (P < 0.02) and oocyte yield (P < 0.002) were positively associated with live birth in all AMA groups. The multivariate analysis revealed that favourable basal FSH, but not AMH or oocyte yield, is associated with live birth in pre-AMA patients independently of other variables (P = 0.012).

Conclusions

The relationship of basal FSH and AMH with IVF/ICSI success changes with maternal age; basal FSH better reflects clinical outcomes probably determined by oocyte quality in pre-AMA patients, while AMH better suits AMA patients.



中文翻译:

母亲年龄影响基础 FSH 和抗苗勒管激素浓度与 ICSI/IVF 后活产的关系

研究问题

基础 FSH 和抗苗勒管激素 (AMH) 浓度与 IVF 后/卵胞浆内单精子注射 (ICSI) 活产的关联是否会随着母亲年龄而变化?

设计

共有 2003 名 IVF/ICSI 患者根据基础 FSH/AMH 分层为一致有利(CF;AMH >1 ng/ml 和 FSH ≤10 IU/l),一致不利(CU;AMH ≤1 ng/ml 和 FSH >10 IU/l)、与有利的 AMH (DFA) 不一致和与有利的 FSH (DFF) 组不一致,以及根据高龄产妇年龄(前 AMA;<35)、AMA-1(≥ 35,≤37)、AMA-2(>37,≤40)和 AMA-3(>40)。在 CF、CU、DFA 和 DFF 组之间比较了 IVF/ICSI 结果,并且分别通过单变量和多变量分析测试了基础 FSH 和 AMH 浓度与活产的关联,分别在 AMA 前和 AMA 组中进行。

结果

在不同年龄组的不一致 AMH/FSH 组中观察到不同的结果模式;良好的基础 FSH 浓度与 AMA 前患者的较高递送率相关,但 AMA 组的递送率较低。在 AMA 前患者中,与 DFA 患者相比,DFF 患者的分娩率更高,但卵母细胞产量更低。在单变量分析中,有利的 AMH ( P  < 0.02) 和卵母细胞产量 ( P  < 0.002) 与所有 AMA 组的活产呈正相关。多变量分析显示,良好的基础 FSH,而不是 AMH 或卵母细胞产量,与 AMA 前患者的活产相关,独立于其他变量(P  = 0.012)。

结论

基础FSH和AMH与IVF/ICSI成功的关系随产妇年龄而变化;基础 FSH 更好地反映了可能由 AMA 前患者的卵母细胞质量决定的临床结果,而 AMH 更适合 AMA 患者。

更新日期:2020-12-14
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