Analysis of the relevance between anti-Müllerian hormone and early spontaneous abortion after IVF/ICSI-ET in young women
Objective To explore the effect of anti-Müllerian hormone(AMH)level on early spontaneous abortion of young women with in vitro fertilization/intracytoplasmic sperm injection and embryo transfer(IVF/ICSI-ET).Methods A retrospective cohort study was performed to analyze the clinical data of the first cycle IVF/ICSI-ET women in Reproductive Medical Center,Peking University Third Hospital from January 2017 to December 2020.Totally 2 640 young women(less than 35 years old,matched according to age with 1∶2 of case-control)were included in this study.They were divided into two groups according to AMH level,880 cases in low AMH group(AMH＜1.1 μg/L)and 1 760 cases in normal AMH group(1.1 μg/L≤AMH＜4.0 μg/L),the general characteristics and early spontaneous abortion rate between the two groups were compared.Binary logistic regression was used to control confounding factors and analyze the relationship between AMH level and early spontaneous abortion.Results 1)There was no significant difference in the age of women and men between the two groups(all P＞0.05).The basal follicle-stimulating hormone[FSH,7.1(6.1,9.2)U/L]in low AMH group was significantly higher than that in normal AMH group[6.9(5.3,8.0)U/L,P＜0.001],while the antral follicle count[6(3,8)],the levels of estrogen[4 446.5(2 999.5,6 264.1)pmol/L]and progesterone[1.9(1.4,2.6)nmol/L]on human chorionic gonadotropin(hCG)injection day were lower than those in the normal AMH group[9(6,12),P＜0.001;6 264.0(4 609.5,8 913.5)pmol/L,P＜0.001;2.0(1.4,2.7)nmol/L,P=0.001].The number of oocytes retrieved(7.4±3.9)and the number of high-quality embryos[3(2,5)]in low AMH group were significantly lower than those in normal AMH group[10.8±3.9,P＜0.001;4(3,7),P＜0.001],and the single embryo transfer rate in low AMH group[14.1%(124/880)]was significantly higher than that in normal AMH group[8.6%(275/1 760),P＜0.001].There was a significant difference in infertility factors between the two groups(P＜0.001).2)The rate of early spontaneous abortion[12.2%(107/880)]in low AMH group was significantly higher than that in normal AMH group[8.9%(156/1 760),P=0.008].There was no significant difference in the rate of late spontaneous abortion between the two groups(P=0.631).3)Binary logistic analysis showed that low AMH level(＜1.1 μg/L)was one of the factors of early spontaneous abortion after adjusting the influence of ovulation induction scheme,the level of estrogen and progesterone on hCG injection day and the number of embryos transferred(OR=1.343,95%CI:1.019-1.769,P=0.036).Conclusion Low AMH level can predict the early spontaneous abortion rate of young women after IVF/ICSI-ET,and its mechanism needs to be further explored.
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