Research question

What is the impact of high serum anti-Müllerian hormone (AMH) concentrations on fertilization and embryo development among infertile women undergoing treatment with assisted reproductive technology (ART)?

Design

Retrospective study of 1036 infertile women undergoing ART; women were divided into three groups according to serum AMH concentrations: AMH <1.1 ng/ml, 1.1–5.0 ng/ml and >5.0 ng/ml. The fertilization and embryo development rates of patients with different AMH concentrations and after stratification according to age were compared.

Results

Women with high AMH concentrations were younger and had higher testosterone concentrations (0.4 ± 0.13 versus 0.3 ± 0.12 versus 0.3 ± 0.08 µg/dl, P < 0.001) than women with low AMH concentrations. However, analysis of the embryo development rate showed negative outcomes for women with high AMH concentrations, including a poor fertilization rate (76.3 ± 17.36 versus 82.1 ± 19.15 versus 82.4 ± 25.38, P = 0.003), and poor day 3 embryo development rate (55.6 ± 23.88 versus 62.6 ± 26.52 versus 62.8 ± 32.65, P = 0.014). Multivariate linear regression analysis showed significantly negative correlations of the AMH concentrations with the fertilization rate (P < 0.001) and day 3 embryo development rate (P = 0.006). Subgroup analysis showed that age 30 years or younger had a significant negative correlation with AMH and the embryo development rate, including the fertilization rate (P < 0.001) and day 3 embryo development rate (P = 0.037).

Conclusion

These results suggest that high serum AMH concentrations, contributing to a hyperandrogenic environment and leading to decreased oocyte developmental competence, may have a negative impact on fertilization and the early stage of embryo development in women undergoing treatment with ART.

中文翻译：

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高血清抗苗勒管激素浓度对受精和胚胎发育率有负面影响

研究问题

高血清抗苗勒管激素 (AMH) 浓度对接受辅助生殖技术 (ART) 治疗的不孕妇女的受精和胚胎发育有何影响？

设计

对 1036 名接受 ART 的不孕妇女的回顾性研究；根据血清AMH浓度将女性分为三组：AMH <1.1 ng/ml、1.1-5.0 ng/ml和>5.0 ng/ml。比较不同AMH浓度和按年龄分层后患者的受精率和胚胎发育率。

结果

AMH 浓度高的女性比 AMH 浓度低的女性更年轻，睾酮浓度更高（0.4 ± 0.13 vs 0.3 ± 0.12 vs 0.3 ± 0.08 µg/dl，P  < 0.001）。然而，胚胎发育率分析显示，AMH 浓度高的女性会出现负面结果，包括受精率低（76.3 ± 17.36 对 82.1 ± 19.15 对 82.4 ± 25.38，P  = 0.003）和第 3 天胚胎发育率差（55.6 ± 23.88 对 62.6 ± 26.52 对 62.8 ± 32.65，P  = 0.014）。多元线性回归分析显示，AMH浓度与受精率（P  < 0.001）和第3天胚胎发育率（P = 0.006)。亚组分析显示，30岁及以下年龄与AMH和胚胎发育率呈显着负相关，包括受精率（P  <0.001）和第3天胚胎发育率（P  =0.037）。

结论

这些结果表明，高浓度的血清 AMH 会导致高雄激素环境并导致卵母细胞发育能力下降，可能对接受 ART 治疗的女性的受精和胚胎发育早期产生负面影响。