Prediction of ovarian reserve function and in vitro fertilization?embryo transfer outcome by FSH/LH,25(OH)D and AMH
Objective To explore the predictive value of ovarian reserve function and the outcome of in vitro fertilization embryo transfer(IVF⁃ET)by follicle stimulating hormone/Luteinizing hormone(FSH/LH),25⁃hydroxyvitamin D(25(OH)D)and Anti Miillerian Hormone(AMH)detection.Methods 112 preg⁃nant women who underwent IVF⁃ET assisted pregnancy in the Second Affiliated Hospital of Zhengzhou Univer⁃sity from August 2020 to September 2022 were selected,the assisted pregnancy were divided into 3 subgroups according to the number of eggs retrieved:low response group(number of retrieved eggs≤3)with 36 cases,normal response group(number of retrieved eggs 4⁃15)with 48 cases,the high response group(number of re⁃trieved eggs≥16)with 28 cases.The FSH/LH,25(OH)D,and AMH levels of patients with different ovarian responders were compared;judged the pregnancy outcomes of patients based on the human chorionic gonadotro⁃pin(β⁃HCG)levels 14 days after treatment with the COH regimen,and collected clinical data of patients with different pregnancy outcomes[age,type of infertility,duration of infertility,number of high⁃quality embryos,total number of retrieved eggs,fertilization rate,number of transplanted embryos,LH/FSH,25(OH)D and AMH levels];the binary Logistic regression analysis was used to risk factors affecting adverse pregnancy out⁃comes;the predictive value of FSH/LH,25(OH)D,and AMH alone and combined on adverse pregnancy out⁃comes was analyzed.Results Comparison of FSH/LH,25(OH)D and AMH levels among different ovarian re⁃sponders:high response group>normal response group>low response group,the difference was statistically sig⁃nificant(P<0.05).Among the 112 patients,77 were in the normal pregnancy group and 35 were in the abnor⁃mal pregnancy group.There was no statistically significant difference in the type of infertility,number of high⁃quality embryos,duration of infertility,total number of retrieved eggs,and fertilization rate between the two groups(P>0.05);there were statistically significant differences in Gn dosage,age,number of transplanted em⁃bryos,FSH/LH,25(OH)D and AMH levels between the two groups(P<0.05).Gn dosage(≥2014.58 U),age(≥39 years),FSH/LH(≥1.8),number of transplanted embryos(≥1.34),25(OH)D(≥25.05 μg/L)and AMH(≥2.92 ng/mL)were independent risk factors for pregnancy outcome(P<0.05).The ROC results showed that the sensitivity and specificity of the three combined to predict pregnancy outcomes were 0.812 and 0.755 respectively.The AUC=0.827(95%CI:0.731~0.923),which was significantly higher than predicted by the three indexes alone(P<0.05).Conclusion FSH/LH,25(OH)D,and AMH levels are elevated in high ovarian response,which can also be used as important indicators for monitoring and preventing adverse pregnancy outcomes in women undergoing IVF⁃ET assisted pregnancy,and the combined predictive value of the three is higher.