长方案促排卵高龄患者抗苗勒管激素水平与成熟卵母细胞数的相关性研究OA
Correlation between anti-Müllerian hormone level and the number of mature oocytes in elderly patients undergoing ovarian stimulation with GnRH agonist long protocol
目的 探讨抗苗勒管激素(AMH)、窦卵泡计数(AFC)和卵泡刺激素(FSH)/黄体生成素(LH)比值(FSH/LH)与高龄(年龄≥35岁)女性促性腺激素释放激素激动剂(GnRH-a)长方案促排卵获得成熟卵母细胞数量的相关性.方法 纳入2021年1月至2024年11月在南京大学医学院附属鼓楼医院生殖医学中心接受辅助生殖治疗,采用GnRH-a长方案促排卵的1 073名年龄≥35岁女性患者为研究对象,根据患者年龄分为35～39岁组(n=976)和≥40岁组(n=97).收集患者基础性激素水平、AFC及成熟卵母细胞数等相关结局数据,通过多元回归分析评估AMH、AFC和FSH/LH比值与成熟卵母细胞数的关联.结果 AMH水平、AFC与成熟卵母细胞数及囊胚形成率均呈显著正相关(P＜0.05),FSH/LH比值与成熟卵母细胞数呈显著负相关(P＜0.05).多元回归分析显示,AMH(β=0.049,P=0.042)和AFC(β=0.316,P＜0.001)对成熟卵母细胞数存在显著正向影响,FSH/LH比值(β=-0.089,P=0.002)、Gn总量(β=-0.165,P＜0.001)对成熟卵母细胞数存在显著负向影响;而年龄和体质量指数(BMI)对成熟卵母细胞数的影响无统计学意义(P＞0.05).年龄分组中,不同年龄组预测结果存在差异:35～39岁组和≥40岁组中,AMH水平、AFC均为成熟卵母细胞数的正面影响因素(P＜0.05),但≥40岁组中FSH/LH比值对成熟卵母细胞数的影响无统计学意义(P＞0.05).结论 在采用GnRH-a长方案促排卵的高龄女性中,AMH水平、AFC及FSH/LH比值均与获得的成熟卵母细胞数显著相关;根据高龄女性的卵巢储备功能评估指标可以较好预测其获卵情况并及时调整促排卵用药.
Objectives:To investigate the correlation between anti-Müllerian hormone(AMH),antral follicle count(AFC),follicle-stimulating hormone(FSH)/luteinizing hormone(LH)ratio and the number of mature oocytes retrieved in elderly women(≥35 years old)undergoing controlled ovarian hyperstimulation with the gonadotropin-releasing hormone(GnRH)agonist long protocol. Methods:A total of 1 073 female patients aged ≥35 years who underwent assisted reproductive technology with the GnRH agonist long protocol at the Reproductive Medicine Center of Nanjing Drum Tower Hospital Affiliated to Medical School of Nanjing University from January 2021 to November 2024 were enrolled.The patients were divided into the 35-39 years old group(n=976)and≥40 years old group(n=97).Data on baseline sex hormone levels,AFC,number of mature oocytes and other related outcomes were collected.Multivariate regression analysis was performed to evaluate the associations of AMH,AFC and FSH/LH ratio with the number of mature oocytes. Results:AMH levels and AFC were significantly positively correlated with the number of mature oocytes and blastocyst formation rate(P＜0.05),while the FSH/LH ratio was significantly negatively correlated with the number of mature oocytes(P＜0.05).Multivariate regression analysis showed that AMH(β=0.049,P=0.042)and AFC(β=0.316,P＜0.001)had significant positive effects on the number of mature oocytes.The FSH/LH ratio(β=-0.089,P=0.002)and total dose of gonadotropin(Gn)use(β=-0.165,P＜0.001)had significant negative effects on the number of mature oocytes.Age and body mass index(BMI)had no statistically significant effects on the number of mature oocytes(P＞0.05).There were differences in predictive outcomes between age subgroups.In both the 35-39 years old group and ≥40 years old group,AMH levels and AFC were positive influencing factors for the number of mature oocytes(P＜0.05),whereas the effect of the FSH/LH ratio on the number of mature oocytes was not statistically significant in the ≥40 years old group(P＞0.05). Conclusions:In elderly women undergoing ovarian stimulation with the GnRH agonist long protocol,AMH level,AFC,and FSH/LH ratio were all significantly correlated with the number of mature oocytes retrieved.These indicators for evaluating ovarian reserve can well predict the oocytes retrieved and allow timely adjustment of ovulation induction medications in elderly women.
丁丽;刘香妍;黄晨阳;王珊珊;孙华
南京大学医学院附属鼓楼医院生殖医学和妇产医学中心,南京 210008南京大学医学院附属鼓楼医院生殖医学和妇产医学中心,南京 210008南京大学医学院附属鼓楼医院生殖医学和妇产医学中心,南京 210008南京大学医学院附属鼓楼医院生殖医学和妇产医学中心,南京 210008南京大学医学院附属鼓楼医院生殖医学和妇产医学中心,南京 210008
医药卫生
高龄女性成熟卵母细胞数抗苗勒管激素窦卵泡计数卵泡刺激素/黄体生成素比值
Elderly womanNumber of mature oocytesAnti-Müllerian hormoneAntral follicle countFollicle-stimulating hormone/luteinizing hormone ratio
《生殖医学杂志》 2026 (5)
587-593,7
2024年度南京鼓楼医院新技术发展基金(XJSFZLX202466)
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