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Discordance between antral follicle counts and anti-Müllerian hormone levels in women undergoing in vitro fertilization.
Reproductive Biology and Endocrinology ( IF 4.4 ) Pub Date : 2019-07-04 , DOI: 10.1186/s12958-019-0497-4 Yangyang Zhang 1 , Yang Xu 1 , Qing Xue 1 , Jing Shang 1 , Xiuli Yang 1 , Xuemin Shan 1 , Yanrong Kuai 1 , Sheng Wang 1 , Cheng Zeng 1
Reproductive Biology and Endocrinology ( IF 4.4 ) Pub Date : 2019-07-04 , DOI: 10.1186/s12958-019-0497-4 Yangyang Zhang 1 , Yang Xu 1 , Qing Xue 1 , Jing Shang 1 , Xiuli Yang 1 , Xuemin Shan 1 , Yanrong Kuai 1 , Sheng Wang 1 , Cheng Zeng 1
Affiliation
BACKGROUND
In general, anti-Müllerian hormone (AMH) is positively associated with antral follicle count (AFC). However, there is often discordance between the AMH level and AFC in clinical practice. In cases of discordance, which indicator should be chosen to predict ovarian response and subsequently develop an ovulation induction protocol? The objective of this study was to investigate which indicator was more accurate in predicting ovarian response and pregnancy outcomes when the AMH level and AFC were discordant.
METHODS
A total of 1121 infertile women undergoing IVF/ICSI were recruited in this study. During the study period, patients were subjected to individualized controlled ovarian hyperstimulation (COH) protocols according to specific characteristics. The AMH levels and AFCs were measured on days 2-3 of the menstrual cycle. Serum samples were obtained to determine AMH levels. Transvaginal ultrasound was performed to determine the AFC. All patients were divided into four groups: Group A had AFCs and AMH levels in the normal range; Group B had normal AFCs and low AMH levels; Group C had low AFCs and normal AMH levels; and Group D had low AFCs and AMH levels.
RESULTS
Two hundred three women (18.11%) showed discordant AFCs and AMH levels. In the two groups with discordant AFCs and AMH levels, namely, Group B and Group C, the oocyte yield, good-quality embryo rate and clinical pregnancy rate were significantly higher in Group B than in Group C. The incidence of poor ovarian response (POR) was significantly lower in Group B than in Group C. According to the stratified analysis of age, for the three categories above the age of 30, oocyte yield was higher in Group B than in Group C. In all age categories, the clinical pregnancy rate was higher in Group B than in Group C.
CONCLUSIONS
Our study demonstrated that approximately one in five patients in clinical practice showed discordance between AFCs and AMH levels. In view of the AFC being better than AMH for predicting POR, the AFC should be the preferred indicator for predicting ovarian response to subsequently develop an optimal individualized COH protocol.
中文翻译:
体外受精妇女的卵泡计数与抗苗勒管激素水平之间的差异。
背景技术通常,抗苗勒氏激素(AMH)与窦卵泡计数(AFC)正相关。但是,在临床实践中,AMH水平和AFC之间经常不一致。如果出现不一致的情况,应该选择哪个指标来预测卵巢反应并随后制定排卵诱导方案?这项研究的目的是调查当AMH水平和AFC不一致时,哪个指标更准确地预测卵巢反应和妊娠结局。方法本研究共招募了1121名接受IVF / ICSI治疗的不育妇女。在研究期间,根据患者的具体特点,对患者进行了个性化的控制性卵巢过度刺激(COH)方案。在月经周期的第2-3天测量AMH水平和AFC。获得血清样品以确定AMH水平。经阴道超声检查以确定AFC。所有患者分为四组:A组的AFC和AMH水平在正常范围内; A组的AFC和AMH水平在正常范围内。B组的AFC正常且AMH含量低;C组的AFC较低且AMH处于正常水平;D组的AFC和AMH含量较低。结果203名妇女(18.11%)的AFC和AMH水平不一致。在AFC和AMH水平不一致的两个组中,即B组和C组,B组的卵母细胞产量,优质胚胎发生率和临床妊娠率显着高于C组。 B组的年龄段(POR)明显低于C组。根据年龄的分层分析,对于30岁以上的三个类别,B组的卵母细胞产量高于C组。在所有年龄段,B组的临床妊娠率均高于C组。结论我们的研究表明,临床实践中大约五分之一的患者显示AFC和AMH之间存在不一致水平。鉴于AFC在预测POR方面比AMH更好,AFC应该是预测卵巢反应的首选指标,以随后制定最佳的个性化COH方案。
更新日期:2019-07-04
中文翻译:
体外受精妇女的卵泡计数与抗苗勒管激素水平之间的差异。
背景技术通常,抗苗勒氏激素(AMH)与窦卵泡计数(AFC)正相关。但是,在临床实践中,AMH水平和AFC之间经常不一致。如果出现不一致的情况,应该选择哪个指标来预测卵巢反应并随后制定排卵诱导方案?这项研究的目的是调查当AMH水平和AFC不一致时,哪个指标更准确地预测卵巢反应和妊娠结局。方法本研究共招募了1121名接受IVF / ICSI治疗的不育妇女。在研究期间,根据患者的具体特点,对患者进行了个性化的控制性卵巢过度刺激(COH)方案。在月经周期的第2-3天测量AMH水平和AFC。获得血清样品以确定AMH水平。经阴道超声检查以确定AFC。所有患者分为四组:A组的AFC和AMH水平在正常范围内; A组的AFC和AMH水平在正常范围内。B组的AFC正常且AMH含量低;C组的AFC较低且AMH处于正常水平;D组的AFC和AMH含量较低。结果203名妇女(18.11%)的AFC和AMH水平不一致。在AFC和AMH水平不一致的两个组中,即B组和C组,B组的卵母细胞产量,优质胚胎发生率和临床妊娠率显着高于C组。 B组的年龄段(POR)明显低于C组。根据年龄的分层分析,对于30岁以上的三个类别,B组的卵母细胞产量高于C组。在所有年龄段,B组的临床妊娠率均高于C组。结论我们的研究表明,临床实践中大约五分之一的患者显示AFC和AMH之间存在不一致水平。鉴于AFC在预测POR方面比AMH更好,AFC应该是预测卵巢反应的首选指标,以随后制定最佳的个性化COH方案。