Effect of anti-Müllerian hormone level on early pregnancy loss rate during the first embryo transfer in in vitro fertilization treatment
10.3760/cma.j.cn101441-20200918-00511
- VernacularTitle:抗苗勒管激素水平对首次胚胎移植术后早期妊娠丢失的影响探讨
- Author:
Yuanhui CHEN
1
;
Yanan ZHANG
1
;
Qian WANG
1
;
Tangmiao LUO
1
;
Siyue XU
1
;
Qingwen ZHANG
1
;
Shaodi ZHANG
1
;
Cuilian ZHANG
1
Author Information
1. 河南省人民医院生殖医学中心，郑州 450003
- Publication Type:Journal Article
- Keywords:
Anti-Müllerian hormone;
Fertilization in vitro;
Embryo transfer;
Early pregnancy loss
- From:
Chinese Journal of Reproduction and Contraception
2022;42(4):350-356
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of anti-Müllerian hormone (AMH) on early pregnancy loss after first embryo transfer during in vitro fertilization (IVF) treatment. Methods:A total of 3973 women with positive human chorionic gonadotropin (hCG) after first embryo transfer from July 2016 to June 2019 in Reproductive Medical Center, Henan Provincial People's Hospital were studied retrospectively. All patients were categorized into four groups according to AMH levels: group A (AMH≤1.97 μg/L), group B (1.97 μg/L5.41 μg/L). Univariate analysis, multivariate logistic regression analysis and curve fitting analysis were used to investigate the effect of AMH level on early pregnancy loss rate.Results:1) The total early pregnancy loss rate of the first transfer cycle was 15.71% (624/3973).There were significant differences in AMH level [(1.21±0.50) μg/L, (2.63±0.38) μg/L, (4.26±0.60) μg/L, (8.26±2.78) μg/L, P<0.001], age [(32.35±5.00) years, (30.77±4.24) years, (29.90±3.96) years, (29.35±3.85) years, P<0.001], antral follicular count of both ovaries (8.01±4.04, 11.46±4.40, 13.55±4.73, 16.08±5.08, P<0.001), number of transfer embryos (1.74±0.44, 1.73±0.45, 1.69±0.46, 1.66±0.47, P<0.001), developmental days of transfer embryos (cleavage embryos/blastocysts) (85.49%/14.51%, 76.42%/23.58%, 69.55%/30.45%, 65.79%/34.21%, P<0.001), type of transfer cycles (fresh transfer/frozen transfer) (75.08%/24.92%, 71.15%/28.85%, 57.79%/42.21%, 39.46%/60.54%, P<0.001) and early pregnancy loss rate (22.12%, 12.25%, 12.76%, 15.64%, P<0.001) among the four groups, while the body mass index, type of infertility and type of fertilization were comparable (all P>0.05). 2) After adjusting for confounding factors, group A was set as control group in multivariate logistic regression analysis, the early pregnancy loss rate was significantly lower in group B (adjusted OR=0.60, 95% CI=0.46-0.79, P<0.001) and group C (adjusted OR=0.70, 95% CI=0.51-0.97, P=0.033) for the total women. Further multivariate logistic regression analysis according to age sub-groups showed that the early pregnancy loss rates of group B (adjusted OR=0.46, 95% CI=0.30-0.71, P<0.001), group C (adjusted OR=0.62, 95% CI=0.39-0.98, P=0.041) and group D (adjusted OR=0.56, 95% CI=0.33-0.93, P=0.026) were significantly lower than those in group A for women no more than 35 years old, while the early pregnancy rates were comparable among the four groups for women aged 35 years or above (all P>0.05). The curve fitting analysis found that the relationship between AMH and early pregnancy loss was a curve line. The early pregnancy loss rate was decreased with the increasing of AMH level and gradually plateaued. Conclusion:For the first embryo transfer cycles, AMH level has some effects on the early pregnancy loss for women no more than 35 years old.
