婦女AMH極低的活產機會

翻自權威的生殖期刊HUMAN REPRODUCTION

 

2011.04.30

 

奧地利的研究

 

婦女AMH極低的活產機會

 

摘要


背景:

研究婦女極低的AMH<0.1-0.4 ng/ml)在人工生殖的治療後活產的能力與這樣的能力是否與年齡有關。

 

方法:

20061月至200910月連續 128AMH 0.4 ng/ml的患者接受IVF治療進行回顧性的研究懷孕率和活產的機會。

 

結果:

患者提出了在平均(±標準差)年齡為 40.8 ± 4.1歲,平均(±標準差)FSH15.7 ± 11.1 mIU / ml且平均(±標準差)AMH 0.2 ± 0.1 ng/ml。一百二十名婦女進行了總共接受了254IVF週期。共20IVF週期有臨床懷孕(7.9%每週期的開始 [95%可信區間(CI):4.9-11.9]; 15.6%的累積 [區間:9.8-23.1])。20個婦女驗孕成功(clinical pregnancy),有12名懷孕婦女(即11個單胞胎和一對雙胞胎)共產下13個活產嬰兒和8例懷孕婦女流產。8位生產是第一個IVF週期(每週期開始 6.3%)和4個生產在隨後的IVF週期(3.2%)。依女性的年齡計算,70名婦女42歲共有16個臨床妊娠懷孕,而其中10例(14.3%)活產,而58>42歲有4個臨床懷孕,其中2例活產(3.4%),相較於小於42歲的族群顯著減少懷孕的機會(P = 0.013)和生產率(P = 0.036)。

 

結論:

極低的AMH,中等但合理的懷孕率和活產率仍然是可能的。極低的AMH並不能代表唯一的指標而暫緩生育治療。

 

原文

 

Hum Reprod. 2011 Apr 30.

 

Live birth chances in women with extremely low-serum anti-Mullerian hormone levels.

Weghofer ADietrich WBarad DHGleicher N.

Source

Department of Obstetrics and Gynecology, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.

Abstract

BACKGROUND To determine whether women with extremely low-serum anti-Mullerian hormone (AMH) levels (<0.1-0.4 ng/ml) still demonstrate live birth potential with assisted reproduction and whether such potential is age dependent. METHODS Between January 2006 and October 2009, 128 consecutive infertility patients with AMH ≤0.4 ng/ml were retrospectively evaluated for pregnancy chances and live birth rates after IVF. RESULTS Patients presented at a mean (±SD) age of 40.8 ± 4.1 years, with mean (±SD) baseline FSH of 15.7 ± 11.1 mIU/ml and mean (±SD) AMH of 0.2 ± 0.1 ng/ml. One hundred and twenty-eight women underwent a total of 254 IVF cycles. Twenty clinical pregnancies were recorded (7.9% per cycle start [95% confidence interval (CI): 4.9-11.9%]; 15.6% cumulative [CI: 9.8-23.1%]). These pregnancies resulted in 13 live births in 12 women (i.e. 11 singletons and a pair of twins) and 8 patients miscarried. Eight deliveries occurred after the first cycle (6.3% per cycle start) and four after subsequent IVF cycles (3.2%). When evaluated according to female age, 70 women ≤42 years presented with 16 clinical pregnancies that resulted in 10 deliveries (14.3%), while 58 patients >42 years presented with four clinical pregnancies that resulted in 2 deliveries (3.4%), representing a reduced pregnancy chance (P = 0.013) and delivery rate (P = 0.036) versus age ≤42 years. CONCLUSIONS With extremely low-serum AMH levels, moderate, but reasonable pregnancy and live birth rates are still possible. Extremely low AMH levels do not seem to represent an appropriate marker for withholding fertility treatment.