BACKGROUND To determine the effects of age and the serum anti-Müllerian hormone (AMH) level on in vitro fertilization (IVF) outcomes, especially among young women with low serum AMH levels and older women with high AMH levels. METHODS This study was a cohort study in which a total of 9431 women aged 20-51 years who were undergoing their first IVF cycles were recruited. Ovarian response parameters included the number of retrieved oocytes, the number of 2 pronuclear zygotes (2PN), and the frequency of good-quality embryos (GQE). Pregnancy outcomes included the clinical pregnancy rate (CPR), live birth rate (LBR), miscarriage rate (MR), and cumulative CPR and LBR (CCPR and CLBR). RESULTS Among women under 35 years of age, the ovarian response, CPR, CCPR, LBR and CLBR (p < 0.01) were significantly lower in the low-AMH group than in the average-AMH and high-AMH groups. In women above 35 years of age, the ovarian response, CPR, CCPR and CLBR (p < 0.01) were significantly higher in the average-AMH and low-AMH groups. The LBR in the older high-AMH group was significantly higher (37.45% vs 20.34%, p < 0.01) than that in the older low-AMH group, but there was no difference (37.45% vs 32.46%, p = 0.11) compared with the older average-AMH group. When there was a discrepancy between age and the AMH level, the young low-AMH group showed a poorer ovarian response but a better CPR (58.01% vs 49.44%, p < 0.01) and LBR (48.52% vs 37.45%, p < 0.01) than the older high-AMH group. However, the CCPR (65.37% vs 66.11%, p = 0.75) and CLBR (56.35% vs 52.89%, p = 0.15) between the two groups were comparable. The conservative CLBR in the two discrepancy groups increased until the third embryo transfer and reached a plateau thereafter. CONCLUSION(S) Even with a relatively low AMH level, young women still had better pregnancy outcomes following IVF than older women. However, increasing the AMH level improves the cumulative outcomes of the older group to a comparable level through a notable and superior ovarian response.

中文翻译：

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在年龄和血清抗苗勒氏激素水平之间存在差异的妇女的IVF结果。

背景技术为了确定年龄和血清抗苗勒管激素（AMH）水平对体外受精（IVF）结果的影响，尤其是在血清AMH水平低的年轻女性和AMH水平高的老年女性中。方法该研究是一项队列研究，共招募了9431名年龄在20-51岁的妇女，他们正在接受首次IVF周期治疗。卵巢反应参数包括取回的卵母细胞数量，2个原核合子（2PN）的数量以及优质胚胎的频率（GQE）。妊娠结局包括临床妊娠率（CPR），活产率（LBR），流产率（MR）以及累积CPR和LBR（CCPR和CLBR）。结果在35岁以下的女性中，卵巢反应，CPR，CCPR，LBR和CLBR（p <0。01）在低AMH组中明显低于平均AMH和高AMH组。在35岁以上的女性中，平均AMH组和低AMH组的卵巢反应，CPR，CCPR和CLBR（p <0.01）显着更高。老年高AMH组的LBR明显高于老年低AMH组（37.45％vs 20.34％，p <0.01），但与老年低AMH组的LBR相比无差异（37.45％vs 32.46％，p = 0.11）与年龄较大的平均AMH组相比。当年龄与AMH水平存在差异时，年轻的低AMH组表现出较差的卵巢反应，但CPR（58.01％vs 49.44％，p <0.01）和LBR（48.52％vs 37.45％，p <0.01）较好。 ），而不是年龄较大的高AMH组。然而，两组的CCPR（65.37％vs 66.11％，p = 0.75）和CLBR（56.35％vs 52.89％，p = 0.15）相当。两个差异组中的保守CLBR增加，直到第三次胚胎转移，此后达到平稳。结论即使AMH水平较低，IVF后年轻女性的妊娠结局仍然比老年女性更好。但是，通过显着和优越的卵巢反应，提高AMH水平可使老年组的累积结局提高到可比较的水平。