期刊
FERTILITY AND STERILITY
卷 105, 期 2, 页码 385-+出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.fertnstert.2015.10.004
关键词
AMH; low AMH; ultralow AMH; ART outcomes; multiple births; prognostic factors
资金
- Beckman-Coulter
- SART
Objective: To assess cycle outcomes when antimullerian hormone (AMH) is ultralow (<= 0.16 ng/mL) and to determine which parameters contribute to the probability of cycle cancellation and/or outcome. Design: Retrospective analysis. Setting: Not applicable. Patient(s): 5,087 (7.3%) fresh and 243 (1.5%) thawed cycles with ultralow AMH values. Intervention(s): Linear and logistic regression, comparison with age-matched cycles with normal AMH concentrations. Main Outcome Measure(s): Cancellation rate; number of retrieved oocytes, embryos, transferred embryos, and cryopreserved embryos; clinical pregnancy, live-birth, and multiple birth rates. Result(s): The total cancellation rate per cycle start for fresh cycles was 54%. Of these, 38.6% of the cycles were canceled before retrieval, and 3.3% of cycles obtained no oocytes at time of retrieval. Of all retrieval attempts, 50.7% had three oocytes or fewer retrieved, and 25.1% had no embryo transfer. The live-birth rates were 9.5% per cycle start. Cycles with ultralow AMH levels compared with age-matched normal AMH cycles demonstrated more than a fivefold greater pre-retrieval cancellation rate, a twofold less live-birth rate per cycle and a 4.5-fold less embryo cryopreservation rate. Conclusion(s): Refusing treatment solely on the basis of ultralow AMH levels is not advisable, but patients should be counseled appropriately about the prognostic factors for cancellation and outcomes. (C) 2016 by American Society for Reproductive Medicine.
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