Objective: To explore the value of anti-Müllerian hormone (AMH) and age in predicting outcomes of patients undergoing in vitro fertilization and embryo transfer treatment. Methods: In this retrospective study, 6 328 Chinese patients who underwent the first in vitro fertilization or intracytoplasmic sperm injection and embryo transfer treatment in Henan Provincial People's Hospital between July 2016 and July 2018 were analyzed. All the patients were categorized into two groups according to pregnancy or not. Baseline data and outcomes of two groups were compared. The regression analysis was conducted to identify the independent factors of clinical pregnancy rates. Furthermore, correlation analysis was performed between AMH and other factors. Results: (1) The total clinical pregnancy rate was 56.86% (3 547/6 238). Age, AMH, basal FSH, antral follicle number (AFC), starting dose of gonadotropin (Gn), total doses of Gn, duration of Gn, number of oocytes, transferable cleavage embryos and transferred embryos were significantly different (all P<0.01). (2) Correlation analysis showed that AMH had significant passive correlation with age, basal FSH, starting dose of Gn and total doses of Gn (all P<0.01), while showed significant positive correlation with AFC, body mass index, duration of Gn, number of oocytes and transferable cleavage embryos (all P<0.01). Of all the factors, AMH had the strongest correlation with AFC (P<0.01). (3) Multivariate logistic regression analysis suggested that age was the independent influencing factor of clinical pregnancy rate (OR=0.938, 95%CI: 0.824-0.952, P<0.01), while AMH not (OR=1.004, 95%CI: 0.984-1.024, P=0.687). In the subgroups according to age, the advanced group (age>35 years old) had lower clinical pregnancy rate and higher cancellation rate for no available embryos. Conclusions: AMH has no predictive value of clinical pregnancy outcomes for patients with in vitro fertilization and embryo transfer treatment, while age has certain predictive value of pregnancy outcomes. AMH level may have indictive value for the evaluation of ovarian reserve.
目的： 探讨抗苗勒管激素（AMH）及年龄对体外受精-胚胎移植临床结局的预测价值。 方法： 回顾性分析2016年7月1日至2018年7月1日在河南省人民医院生殖医学中心首次接受体外受精或卵母细胞胞质内单精子注射法-胚胎移植治疗的6 238例不孕症患者的临床资料，根据每周期首次胚胎移植后是否临床妊娠分为妊娠组和未妊娠组，比较两组间的一般情况，并进行AMH相关因素的分析以及临床妊娠率影响因素的logistic回归分析。 结果： （1）每周期临床妊娠率为56.86%（3 547/6 238）。两组患者间年龄、AMH、基础FSH、窦卵泡数（AFC）、促性腺激素（Gn）启动量、Gn总量、Gn使用天数、获卵数、卵裂期可移植胚胎数、移植胚胎数均有显著差异（P均<0.01）。（2）相关性分析显示，AMH与年龄、基础FSH、Gn启动量、Gn总量呈显著负相关（P均<0.01），与AFC、体质指数、Gn使用天数、获卵数、卵裂期可移植胚胎数呈显著正相关（P均<0.01）。其中，AMH与AFC的相关性最强（Pearson相关分析r=0.685，偏相关分析r=0.619，P均<0.01）。（3）多因素logistic回归分析显示，年龄是临床妊娠率的独立影响因素（OR=0.938，95%CI为0.824~0.952，P<0.01），而AMH对是否临床妊娠无明显的预测价值（OR=1.004，95%CI为0.984~1.024，P=0.687）。年龄与每周期临床妊娠率的曲线拟合结果显示，年龄≤35岁时临床妊娠率相对稳定，当年龄>35岁后，临床妊娠率明显下降。 结论： AMH对体外受精-胚胎移植的临床结局没有预测价值，而年龄对临床结局有一定的预测价值；AMH可以作为卵巢储备功能的参考指标。.
Keywords: Age factors; Anti-mullerian hormone; Embryo transfer; Fertilization in vitro; Pregnancy outcome.