卵巢储备功能低下患者血清AMH、Betatrophin水平与卵巢反应性、IVF-ET妊娠结局关系

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中文摘要：目的:探讨卵巢储备功能低下(DOR)患者血清抗苗勒管激素(AMH)、促代谢因子(Betatrophin)水平与卵巢反应性及体外受精-胚胎移植(IVF-ET)妊娠结局的关系.方法:收集2019年12月-2022年12月在本院行IVF-ET的DOR患者137例临床资料,根据卵巢反应性将患者分为低反应组(n=112)、正常反应组(n=16)、高反应组(n=9);根据妊娠结局将患者分为妊娠成功组(n=44)和妊娠失败组(n=93).酶联免疫吸附法检测血清AMH、Betatro-phin水平,受试者工作特性(ROC)曲线评估2项指标预测IVF-ET妊娠结局价值;多因素logistic回归分析影响妊娠的因素.结果:低反应组、正常组、高反应组血清AMH水平(0.49±0.13 ng/ml、0.98±0.21 ng/ml、1.05±0.26 ng/ml)依次升高,血清 Betatrophin 水平(156.95±16.33 pg/ml、112.17±13.42 pg/ml、92.64±11.03 pg/ml)依次降低;妊娠成功组血清 AMH 水平(1.07±0.36 ng/ml)高于妊娠失败组(0.34±0.19 ng/ml),Betatrophin 水平(136.29±14.42 pg/ml)低于妊娠失败组(216.16±21.05 pg/ml)(均 P＜0.05).血清 AMH、Betatrophin 预测 DOR 患者 IVF-ET 妊娠结局的曲线下面积(AUC)(95％CI)别为0.857、0.771,两项指标联合预测的AUC为0.904.多因素logistic回归分析显示,卵泡刺激素/促黄体生成素比值≥2、卵巢低反应、AMH≤0.71 ng/ml、Betatrophin≥176.23 pg/ml是DOR患者IVF-ET妊娠失败的独立危险因素(P＜0.05).结论:血清AMH、Betatrophin水平与DOR患者卵巢反应性、IVF-ET妊娠结局有关,二者有望作为预测DOR患者IVF-ET妊娠结局的生物标记物.

外文标题：Correlation between the levels of serum anti-mullerian hormone and Betatrophin of patients with low ovarian reserve and their ovarian reactivity and pregnancy outcomes after in vitro fertilization-embryo transfer

外文摘要：Objective:To explore the correlation between the levels of serum anti-mullerian hormone(AMH)and Be-tatrophin of patients with low ovarian reserve(LOR)and their ovarian reactivity and pregnancy outcomes after in vitro fertilization-embryo transfer(IVF-ET).Methods:The clinical data of 137 patients with LOR who had undergone IVF-ET from December 2019 to December 2022 were collected in this study.These patients were divided into group A(112 patients with LOR),group B(16 patients with normal ovarian reactivity)and group C(9 patients with high ovarian reactivity)according to their ovarian reactivity.These patients also were divided into group D(44 patients with success pregnancy)and group E(93 patients with pregnancy failure)according to their pregnancy situation.Enzyme-linked im-munosorbent assay was used to detect the serum AMH and Betatrophin levels of these patients.Receiver operator char-acteristic(ROC)curve was used to evaluate the predictive value of the serum AMH and Betatrophin levels of the pa-tients with LOR for their pregnancy outcomes after IVF-ET.The influencing factors of the pregnancy outcomes of the patients with LOR after IVF-ET were explored by multivariate logistic regression.Results:The serum AMH level of the patients in group A(0.49±0.13 ng/ml),in group B(0.98±0.21 ng/ml)and in group C(1.05±0.26 ng/ml)had increased gradually.The serum Betatrophin level of the patients in group A(156.95±16.33 pg/ml),in group B(112.17±13.42 pg/ml)and in group C(92.64±11.03 pg/ml)had decreased gradually.The level of serum AMH level(1.07±0.36 ng/ml)of the patients in group D was significantly higher than that(0.34±0.19 ng/ml)of the patients in group E,and the level of Betatrophin(136.29±14.42 pg/ml)of the patients in group D was significantly lower than that(216.16±21.05 pg/ml)of the patients in group E(all P＜0.05).The area under the curve(AUC)of the levels of serum AMH level,the Betatrophin level and the combined levels of serum AMH and Betatrophin of the patients with LOD for predicting their pregnancy outcomes after IVF-ET was 0.857,0.771 and 0.904,respectively.Multivariate lo-gistic regression analysis showed that the follicle-stimulating hormone/luteinizing hormone ratio ≥2,the poor ovarian response,the AMH level ≤0.71ng/ml,and the Betatrophin level ≥176.23pg/ml of the patients with LOD were the independent risk factors of their pregnancy failure after IVF-ET(P＜0.05).Conclusion:The serum AMH and Betat-rophin levels of the patients with LOD are associated with their ovarian reactivity and pregnancy outcomes after IVF-ET,and both of which can be used as the potential biomarkers to predict the pregnancy outcomes of the patients after IVF-ET.

外文关键词：

In vitro fertilization-embryo transferLow ovarian reserveAnti-mullerian hormoneBetatrophinOvari-an responsivenessPregnancy outcomesInfluence factor

作者：

李翠明、韦敏、白华

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作者单位：

广西壮族自治区妇幼保健院(南宁,530003)

关键词：

体外受精-胚胎移植卵巢储备功能低下抗苗勒管激素促代谢因子卵巢反应性妊娠结局影响因素

基金：

广西壮族自治区卫生和计划生育委员会自筹经费科研课题

项目编号：

Z20180076

出版年：

2024

DOI：

10.3969/j.issn.1004-8189.2024.07.025

中国计划生育学杂志

国家人口计生委科学技术研究所

中国计划生育学杂志

CSTPCD

影响因子：1.759

ISSN：1004-8189

年,卷(期)：2024.32(7)