1.Value of anti-Müllerian hormone in predicting pregnant outcomes of polycystic ovary syndrome patients undergone assisted reproductive technology
Yi LI ; Jiaqi TAN ; Zhuoyao MAI ; Dongzi YANG
Chinese Journal of Obstetrics and Gynecology 2018;53(1):23-30
Objective Explore the value of anti-Müllerian hormone(AMH)in predicting pregnant outcomes of polycystic ovary syndrome (PCOS) patients undergone assisted reproductive technology. Methods The study totally recruited 1697 patients who underwent the first in vitro fertilization (IVF) or intracytoplasmic sperm injection(ICSI)cycle in Sun Yat-sen Memorial Hospital from the January 2014 to December 2015. The patients were divided into two groups based on the age<35(n=758)and≥35 years old (n=939), compare the basic data and pregnant outcomes of controlled ovarian hyerstimulation. Spearman correlation method was conducted to analyze the relations between AMH and clinical outcomes. The logistic regression method and partial correlation analysis were used to judge the main factors which determine pregnancy outcomes by controlled the confounding factors. The receiver operating characteristic curve (ROC)was used to evaluate the predictive sensitivity and specificity of AMH. Results In the group of PCOS patient younger than 35 years, AMH were correlated with the number of antral follicles(r=0.388)and retrieved oocytes (r=0.235). When the effect of total dosage and starting dosage of gonadotropin were controlled, AMH was still significantly associated with the number of retrieved oocytes(P<0.05). AMH had no predictive value for the clinical pregnancy of PCOS patient younger than 35 years (area under ROC curve=0.481, P=0.768). In the group of PCOS patient≥35 years old, AMH were correlated with the number of antral follicles (r=0.450), retrieved oocytes (r=0.399), available embryo (r=0.336) and high quality embryo(r=0.235). When the effect of total dosage and starting dosage of gonadotropin were controlled, the correlations were still significant between those indexes(all P<0.05). AMH had no predictive value for the clinical pregnancy of PCOS patient≥35 years old(area under ROC curve=0.535, P=0.560). However, the clinical pregnancy rate of the group of PCOS patient≥35 years old was slightly higher than the control group (P=0.062). Conclusions AMH has no predictive value for the pregnancy outcome of PCOS patient. The pregnancy rate of PCOS patient≥35 years old is slightly higher than the younger group, because the PCOS patient may have better ovarian reserve.
2.Thyroid autoimmunity increases the risk of second pregnancy abortion in people with unexplained recurrent abortion
Zhaorui WANG ; Xiaohui JI ; Yihong GUO ; Yingcui LIANG ; Zhuang LI ; Zhuoyao MAI ; Menglan ZHU ; Lujing CHEN ; Hui CHEN
Journal of Chinese Physician 2024;26(11):1607-1612
Objective:To investigate the relationship between thyroid autoimmunity and pregnancy outcome in patients with unexplained recurrent abortion.Methods:A retrospective cohort study of 354 patients with normal thyroid function with recurrent abortion of unknown cause admitted to Sun Yat-sen Memorial Hospital, Sun Yat-sen University from January 2015 to June 2022 was used to detect thyroid antibody and thyroid function levels during pregnancy or early pregnancy. They were divided into TAI group ( n=144) and non-TAI group ( n=210) according to whether thyroid autoimmunity (TAI) was complicated or not. Tracking pregnancy outcomes. Results:Compared with the non-TAI group, the TAI group had a higher proportion of pregnancy outcomes resulting in miscarriage [42.4%(61/144) vs 27.1%(57/210), P=0.004]. In patients with unexplained recurrent abortion, TAI significantly increased the risk of spontaneous abortion [ OR(95% CI): 2.13(1.34, 3.41), P=0.001]. Positive TPOAb or TgAb also increased the risk of spontaneous abortion [ OR(95% CI): 2.18(1.37, 3.50), P=0.001; OR(95% CI): 2.33(1.31, 4.13), P=0.004]. TAI, TPOAb and TgAb had no significant interaction with age ( P=0.482, 0.724, 0.740). Conclusions:TAI is positively associated with the risk of spontaneous abortion in patients with unexplained recurrent abortion. TAI may be a potential risk factor for unexplained recurrent abortion, expanding the diagnosis and treatment of unexplained recurrent abortion.