1.Predictive value of whole blood cell derived inflammatory markers in combination with NT-proBNP on the prognosis of patients with chronic heart failure
Zhibin LIN ; Zhonghua TENG ; Yanru XU ; Yunsheng DENG ; Guilian LIANG ; Hengyan DENG ; Qingchun ZENG
Chinese Journal of Cardiology 2025;53(2):143-150
Objective:To evaluate the predictive value of whole blood cell derived inflammatory marker (including systemic immunoinflammatory index (SII), systemic inflammatory response index (SIRI), neutrophil count/lymphocyte count (NLR), platelet count/lymphocyte count (PLR), and monocyte count/lymphocyte count (MLR)) and in combination with N-terminal pro-B-type natriuretic peptide (NT-proBNP) on the prognosis of patients with chronic heart failure.Methods:This study was a retrospective cohort study. Patients with chronic heart failure hospitalized in the Department of Cardiovascular Medicine, Nanfang Hospital, Southern Medical University from January 2019 to August 2022 were enrolled. Patients were followed up and were divided into survival group and death group according to the follow-up results. Clinical characteristics of the two groups were compared. Receiver operating characteristic (ROC) curve was used to determine the optimal cut-off value of each whole blood cell derived inflammatory marker for predicting all-cause death in patients with chronic heart failure. Kaplan-Meier survival curve was drawn, and log-rank test was used to compare the difference in survival of chronic heart failure patients with different levels of whole blood cell derived inflammatory markers. Univariate and multivariate Cox proportional hazards models were used to analyze the effects of whole blood cell derived inflammatory markers and NT-proBNP on the all-cause death of patients with chronic heart failure. ROC curve was used to analyze the predictive value of whole blood cell derived inflammatory markers combined with NT-proBNP on the prognosis of patients with chronic heart failure.Results:A total of 324 patients with heart failure aged (64.76±13.78) years were enrolled, with 212 males (65.43%). 297 patients (91.67%) completed follow-up, 27 patients (8.33%) were lost to follow-up. The follow-up time was 24.0 (18.0, 41.8) months. There were 258 patients in the survival group and 66 patients in the death group. The optimal cut-off values of SII, SIRI, NLR, PLR and MLR determined by ROC curve were 739.83, 1.65, 3.14, 151.95 and 0.37, respectively. Kaplan-Meier survival curve analysis showed that patients with chronic heart failure with high levels of SII (≥739.83), SIRI (≥1.65), NLR (≥3.14), PLR (≥151.95) and MLR (≥0.37) had higher incidence of all-cause death than patients with low levels of inflammatory markers (all P<0.001). Multivariate Cox proportional hazard regression analysis showed that age ( HR=1.04, 95% CI 1.01-1.06, P=0.002), NT-proBNP ( HR=2.93, 95% CI 1.64-5.23, P<0.001), SII≥739.83 ( HR=3.27, 95% CI 1.18-9.02, P=0.022) and PLR≥151.95 ( HR=2.67, 95% CI 1.02-6.96, P=0.045) were independent predictors of all-cause death in patients with chronic heart failure. ROC curve analysis showed that the predictive value of SII and PLR combined with NT-proBNP ( AUC=0.850) for the prognosis of patients with chronic heart failure was better than that of SII ( AUC=0.779)、PLR ( AUC=0.782)、NT-proBNP ( AUC=0.727) and CRP ( AUC=0.668) alone (all P<0.001). Conclusions:Whole blood cell derived inflammatory markers——SII, PLR, and NT-pro BNP were independently associated with all-cause death in patients with chronic heart failure. SII and PLR can independently predict the prognosis of patients with chronic heart failure, combination of SII and PLR with NT-pro BNP has better predictive value for the prognosis of patients with chronic heart failure.
2.Predictive value of whole blood cell derived inflammatory markers in combination with NT-proBNP on the prognosis of patients with chronic heart failure
Zhibin LIN ; Zhonghua TENG ; Yanru XU ; Yunsheng DENG ; Guilian LIANG ; Hengyan DENG ; Qingchun ZENG
Chinese Journal of Cardiology 2025;53(2):143-150
Objective:To evaluate the predictive value of whole blood cell derived inflammatory marker (including systemic immunoinflammatory index (SII), systemic inflammatory response index (SIRI), neutrophil count/lymphocyte count (NLR), platelet count/lymphocyte count (PLR), and monocyte count/lymphocyte count (MLR)) and in combination with N-terminal pro-B-type natriuretic peptide (NT-proBNP) on the prognosis of patients with chronic heart failure.Methods:This study was a retrospective cohort study. Patients with chronic heart failure hospitalized in the Department of Cardiovascular Medicine, Nanfang Hospital, Southern Medical University from January 2019 to August 2022 were enrolled. Patients were followed up and were divided into survival group and death group according to the follow-up results. Clinical characteristics of the two groups were compared. Receiver operating characteristic (ROC) curve was used to determine the optimal cut-off value of each whole blood cell derived inflammatory marker for predicting all-cause death in patients with chronic heart failure. Kaplan-Meier survival curve was drawn, and log-rank test was used to compare the difference in survival of chronic heart failure patients with different levels of whole blood cell derived inflammatory markers. Univariate and multivariate Cox proportional hazards models were used to analyze the effects of whole blood cell derived inflammatory markers and NT-proBNP on the all-cause death of patients with chronic heart failure. ROC curve was used to analyze the predictive value of whole blood cell derived inflammatory markers combined with NT-proBNP on the prognosis of patients with chronic heart failure.Results:A total of 324 patients with heart failure aged (64.76±13.78) years were enrolled, with 212 males (65.43%). 297 patients (91.67%) completed follow-up, 27 patients (8.33%) were lost to follow-up. The follow-up time was 24.0 (18.0, 41.8) months. There were 258 patients in the survival group and 66 patients in the death group. The optimal cut-off values of SII, SIRI, NLR, PLR and MLR determined by ROC curve were 739.83, 1.65, 3.14, 151.95 and 0.37, respectively. Kaplan-Meier survival curve analysis showed that patients with chronic heart failure with high levels of SII (≥739.83), SIRI (≥1.65), NLR (≥3.14), PLR (≥151.95) and MLR (≥0.37) had higher incidence of all-cause death than patients with low levels of inflammatory markers (all P<0.001). Multivariate Cox proportional hazard regression analysis showed that age ( HR=1.04, 95% CI 1.01-1.06, P=0.002), NT-proBNP ( HR=2.93, 95% CI 1.64-5.23, P<0.001), SII≥739.83 ( HR=3.27, 95% CI 1.18-9.02, P=0.022) and PLR≥151.95 ( HR=2.67, 95% CI 1.02-6.96, P=0.045) were independent predictors of all-cause death in patients with chronic heart failure. ROC curve analysis showed that the predictive value of SII and PLR combined with NT-proBNP ( AUC=0.850) for the prognosis of patients with chronic heart failure was better than that of SII ( AUC=0.779)、PLR ( AUC=0.782)、NT-proBNP ( AUC=0.727) and CRP ( AUC=0.668) alone (all P<0.001). Conclusions:Whole blood cell derived inflammatory markers——SII, PLR, and NT-pro BNP were independently associated with all-cause death in patients with chronic heart failure. SII and PLR can independently predict the prognosis of patients with chronic heart failure, combination of SII and PLR with NT-pro BNP has better predictive value for the prognosis of patients with chronic heart failure.
3.The Analysis of Influencing Factors of Pregnancy Failure of IVF/ICSI in Pa-tients with Low Serum AMH Level
Lan LIU ; Ying ZHANG ; Yanru ZENG ; Qi CAO ; Tian TANG
Journal of Practical Obstetrics and Gynecology 2024;40(11):933-939
Objective:The study aimed to investigate the factors of pregnancy failures in patients with low ser-um anti-Müllerian hormone(AMH)level after in vitro fertilization(IVF)or intracytoplasmic sperm injection(ICSI).Method:The clinical outcome of 1184 cycles in 931 patients with serum AMH<1.1 ng/ml undergoing IVF/ICSI at the Department of Reproductive Medicine of West China Second Hospital,Sichuan University between January 1,2020 and December 31,2020,was retrospectively studied.In total,503 patients(525 cycles)underwent embryo transfer,including clinical pregnant group in 193 patients(193 cycles)and clinical non-pregnant group in 310 pa-tients(332 cycles).All of the patients were divided into three different groups according to their chronological age(<35,35-<40,40-51 years old)and five different serum AMH levels(<0.06 ng/ml,0.06-<0.20 ng/ml,0.20-<0.50 ng/ml,0.50-<0.80 ng/ml,0.80-<1.10 ng/ml),to explore the relationship with IVF pregnancy outcomes.Multivariate Logistic regression analysis was carried out to explore factors affecting pregnancy out-comes afer IVF/ICSI.Results:①Compared with the clinical pregnancy group,the clinical non-pregnant patients were older,AMH level and antral follicle count(AFC)were lower,the number of MII,2PN,available embryos and top quality embryos were also lower,and endometrial thickness at oocyte pickup(OPU)was thinner,and differ-ences above were statistically significant(P<0.05).②AMH level,AFC,BMI,total Gn and MII number were signifi-cantly different among different age groups(P<0.05).The clinical pregnancy rate per transplantation cycle,per oocyte pickup cycle and per ovulation induction cycle also had statistically significant differences(P<0.001),and the pregnancy rate showed a decreasing trend with the increase of age.③There were significant differences in clinical pregnancy rate per transplantation cycle,per oocyte pickup cycle and per ovulation induction cycle among different ranges of low level AMH(P<0.05).④Multivariable Logistic regression analysis confirmed that the prob-ability of pregnancy in patients with low AMH level after transfering embryo was significantly affected by patients'age(P=0.002).Receiver operating characteristic(ROC)curve showed that the best cut-off value for predicting clinical pregnancy was 35.5 years,the area under the curve(AUC)was 0.634(95%CI 0.586-0.682,P<0.001).Conclusions:Patients with low AMH level(<1.1 ng/ml)still have a good chance of pregnancy after IVF/ICSI treatment,and the most notable influencing factor is the patient's chronological age,rather than AMH.When the actual age of patients is less than 35.5 years,the clinical pregnancy outcome after transferring embryo is better e-ven with low AMH level.
4.The Analysis of Influencing Factors of Pregnancy Failure of IVF/ICSI in Pa-tients with Low Serum AMH Level
Lan LIU ; Ying ZHANG ; Yanru ZENG ; Qi CAO ; Tian TANG
Journal of Practical Obstetrics and Gynecology 2024;40(11):933-939
Objective:The study aimed to investigate the factors of pregnancy failures in patients with low ser-um anti-Müllerian hormone(AMH)level after in vitro fertilization(IVF)or intracytoplasmic sperm injection(ICSI).Method:The clinical outcome of 1184 cycles in 931 patients with serum AMH<1.1 ng/ml undergoing IVF/ICSI at the Department of Reproductive Medicine of West China Second Hospital,Sichuan University between January 1,2020 and December 31,2020,was retrospectively studied.In total,503 patients(525 cycles)underwent embryo transfer,including clinical pregnant group in 193 patients(193 cycles)and clinical non-pregnant group in 310 pa-tients(332 cycles).All of the patients were divided into three different groups according to their chronological age(<35,35-<40,40-51 years old)and five different serum AMH levels(<0.06 ng/ml,0.06-<0.20 ng/ml,0.20-<0.50 ng/ml,0.50-<0.80 ng/ml,0.80-<1.10 ng/ml),to explore the relationship with IVF pregnancy outcomes.Multivariate Logistic regression analysis was carried out to explore factors affecting pregnancy out-comes afer IVF/ICSI.Results:①Compared with the clinical pregnancy group,the clinical non-pregnant patients were older,AMH level and antral follicle count(AFC)were lower,the number of MII,2PN,available embryos and top quality embryos were also lower,and endometrial thickness at oocyte pickup(OPU)was thinner,and differ-ences above were statistically significant(P<0.05).②AMH level,AFC,BMI,total Gn and MII number were signifi-cantly different among different age groups(P<0.05).The clinical pregnancy rate per transplantation cycle,per oocyte pickup cycle and per ovulation induction cycle also had statistically significant differences(P<0.001),and the pregnancy rate showed a decreasing trend with the increase of age.③There were significant differences in clinical pregnancy rate per transplantation cycle,per oocyte pickup cycle and per ovulation induction cycle among different ranges of low level AMH(P<0.05).④Multivariable Logistic regression analysis confirmed that the prob-ability of pregnancy in patients with low AMH level after transfering embryo was significantly affected by patients'age(P=0.002).Receiver operating characteristic(ROC)curve showed that the best cut-off value for predicting clinical pregnancy was 35.5 years,the area under the curve(AUC)was 0.634(95%CI 0.586-0.682,P<0.001).Conclusions:Patients with low AMH level(<1.1 ng/ml)still have a good chance of pregnancy after IVF/ICSI treatment,and the most notable influencing factor is the patient's chronological age,rather than AMH.When the actual age of patients is less than 35.5 years,the clinical pregnancy outcome after transferring embryo is better e-ven with low AMH level.
5.The Analysis of Influencing Factors of Pregnancy Failure of IVF/ICSI in Pa-tients with Low Serum AMH Level
Lan LIU ; Ying ZHANG ; Yanru ZENG ; Qi CAO ; Tian TANG
Journal of Practical Obstetrics and Gynecology 2024;40(11):933-939
Objective:The study aimed to investigate the factors of pregnancy failures in patients with low ser-um anti-Müllerian hormone(AMH)level after in vitro fertilization(IVF)or intracytoplasmic sperm injection(ICSI).Method:The clinical outcome of 1184 cycles in 931 patients with serum AMH<1.1 ng/ml undergoing IVF/ICSI at the Department of Reproductive Medicine of West China Second Hospital,Sichuan University between January 1,2020 and December 31,2020,was retrospectively studied.In total,503 patients(525 cycles)underwent embryo transfer,including clinical pregnant group in 193 patients(193 cycles)and clinical non-pregnant group in 310 pa-tients(332 cycles).All of the patients were divided into three different groups according to their chronological age(<35,35-<40,40-51 years old)and five different serum AMH levels(<0.06 ng/ml,0.06-<0.20 ng/ml,0.20-<0.50 ng/ml,0.50-<0.80 ng/ml,0.80-<1.10 ng/ml),to explore the relationship with IVF pregnancy outcomes.Multivariate Logistic regression analysis was carried out to explore factors affecting pregnancy out-comes afer IVF/ICSI.Results:①Compared with the clinical pregnancy group,the clinical non-pregnant patients were older,AMH level and antral follicle count(AFC)were lower,the number of MII,2PN,available embryos and top quality embryos were also lower,and endometrial thickness at oocyte pickup(OPU)was thinner,and differ-ences above were statistically significant(P<0.05).②AMH level,AFC,BMI,total Gn and MII number were signifi-cantly different among different age groups(P<0.05).The clinical pregnancy rate per transplantation cycle,per oocyte pickup cycle and per ovulation induction cycle also had statistically significant differences(P<0.001),and the pregnancy rate showed a decreasing trend with the increase of age.③There were significant differences in clinical pregnancy rate per transplantation cycle,per oocyte pickup cycle and per ovulation induction cycle among different ranges of low level AMH(P<0.05).④Multivariable Logistic regression analysis confirmed that the prob-ability of pregnancy in patients with low AMH level after transfering embryo was significantly affected by patients'age(P=0.002).Receiver operating characteristic(ROC)curve showed that the best cut-off value for predicting clinical pregnancy was 35.5 years,the area under the curve(AUC)was 0.634(95%CI 0.586-0.682,P<0.001).Conclusions:Patients with low AMH level(<1.1 ng/ml)still have a good chance of pregnancy after IVF/ICSI treatment,and the most notable influencing factor is the patient's chronological age,rather than AMH.When the actual age of patients is less than 35.5 years,the clinical pregnancy outcome after transferring embryo is better e-ven with low AMH level.
6.The Analysis of Influencing Factors of Pregnancy Failure of IVF/ICSI in Pa-tients with Low Serum AMH Level
Lan LIU ; Ying ZHANG ; Yanru ZENG ; Qi CAO ; Tian TANG
Journal of Practical Obstetrics and Gynecology 2024;40(11):933-939
Objective:The study aimed to investigate the factors of pregnancy failures in patients with low ser-um anti-Müllerian hormone(AMH)level after in vitro fertilization(IVF)or intracytoplasmic sperm injection(ICSI).Method:The clinical outcome of 1184 cycles in 931 patients with serum AMH<1.1 ng/ml undergoing IVF/ICSI at the Department of Reproductive Medicine of West China Second Hospital,Sichuan University between January 1,2020 and December 31,2020,was retrospectively studied.In total,503 patients(525 cycles)underwent embryo transfer,including clinical pregnant group in 193 patients(193 cycles)and clinical non-pregnant group in 310 pa-tients(332 cycles).All of the patients were divided into three different groups according to their chronological age(<35,35-<40,40-51 years old)and five different serum AMH levels(<0.06 ng/ml,0.06-<0.20 ng/ml,0.20-<0.50 ng/ml,0.50-<0.80 ng/ml,0.80-<1.10 ng/ml),to explore the relationship with IVF pregnancy outcomes.Multivariate Logistic regression analysis was carried out to explore factors affecting pregnancy out-comes afer IVF/ICSI.Results:①Compared with the clinical pregnancy group,the clinical non-pregnant patients were older,AMH level and antral follicle count(AFC)were lower,the number of MII,2PN,available embryos and top quality embryos were also lower,and endometrial thickness at oocyte pickup(OPU)was thinner,and differ-ences above were statistically significant(P<0.05).②AMH level,AFC,BMI,total Gn and MII number were signifi-cantly different among different age groups(P<0.05).The clinical pregnancy rate per transplantation cycle,per oocyte pickup cycle and per ovulation induction cycle also had statistically significant differences(P<0.001),and the pregnancy rate showed a decreasing trend with the increase of age.③There were significant differences in clinical pregnancy rate per transplantation cycle,per oocyte pickup cycle and per ovulation induction cycle among different ranges of low level AMH(P<0.05).④Multivariable Logistic regression analysis confirmed that the prob-ability of pregnancy in patients with low AMH level after transfering embryo was significantly affected by patients'age(P=0.002).Receiver operating characteristic(ROC)curve showed that the best cut-off value for predicting clinical pregnancy was 35.5 years,the area under the curve(AUC)was 0.634(95%CI 0.586-0.682,P<0.001).Conclusions:Patients with low AMH level(<1.1 ng/ml)still have a good chance of pregnancy after IVF/ICSI treatment,and the most notable influencing factor is the patient's chronological age,rather than AMH.When the actual age of patients is less than 35.5 years,the clinical pregnancy outcome after transferring embryo is better e-ven with low AMH level.
7.The Analysis of Influencing Factors of Pregnancy Failure of IVF/ICSI in Pa-tients with Low Serum AMH Level
Lan LIU ; Ying ZHANG ; Yanru ZENG ; Qi CAO ; Tian TANG
Journal of Practical Obstetrics and Gynecology 2024;40(11):933-939
Objective:The study aimed to investigate the factors of pregnancy failures in patients with low ser-um anti-Müllerian hormone(AMH)level after in vitro fertilization(IVF)or intracytoplasmic sperm injection(ICSI).Method:The clinical outcome of 1184 cycles in 931 patients with serum AMH<1.1 ng/ml undergoing IVF/ICSI at the Department of Reproductive Medicine of West China Second Hospital,Sichuan University between January 1,2020 and December 31,2020,was retrospectively studied.In total,503 patients(525 cycles)underwent embryo transfer,including clinical pregnant group in 193 patients(193 cycles)and clinical non-pregnant group in 310 pa-tients(332 cycles).All of the patients were divided into three different groups according to their chronological age(<35,35-<40,40-51 years old)and five different serum AMH levels(<0.06 ng/ml,0.06-<0.20 ng/ml,0.20-<0.50 ng/ml,0.50-<0.80 ng/ml,0.80-<1.10 ng/ml),to explore the relationship with IVF pregnancy outcomes.Multivariate Logistic regression analysis was carried out to explore factors affecting pregnancy out-comes afer IVF/ICSI.Results:①Compared with the clinical pregnancy group,the clinical non-pregnant patients were older,AMH level and antral follicle count(AFC)were lower,the number of MII,2PN,available embryos and top quality embryos were also lower,and endometrial thickness at oocyte pickup(OPU)was thinner,and differ-ences above were statistically significant(P<0.05).②AMH level,AFC,BMI,total Gn and MII number were signifi-cantly different among different age groups(P<0.05).The clinical pregnancy rate per transplantation cycle,per oocyte pickup cycle and per ovulation induction cycle also had statistically significant differences(P<0.001),and the pregnancy rate showed a decreasing trend with the increase of age.③There were significant differences in clinical pregnancy rate per transplantation cycle,per oocyte pickup cycle and per ovulation induction cycle among different ranges of low level AMH(P<0.05).④Multivariable Logistic regression analysis confirmed that the prob-ability of pregnancy in patients with low AMH level after transfering embryo was significantly affected by patients'age(P=0.002).Receiver operating characteristic(ROC)curve showed that the best cut-off value for predicting clinical pregnancy was 35.5 years,the area under the curve(AUC)was 0.634(95%CI 0.586-0.682,P<0.001).Conclusions:Patients with low AMH level(<1.1 ng/ml)still have a good chance of pregnancy after IVF/ICSI treatment,and the most notable influencing factor is the patient's chronological age,rather than AMH.When the actual age of patients is less than 35.5 years,the clinical pregnancy outcome after transferring embryo is better e-ven with low AMH level.
8.The Analysis of Influencing Factors of Pregnancy Failure of IVF/ICSI in Pa-tients with Low Serum AMH Level
Lan LIU ; Ying ZHANG ; Yanru ZENG ; Qi CAO ; Tian TANG
Journal of Practical Obstetrics and Gynecology 2024;40(11):933-939
Objective:The study aimed to investigate the factors of pregnancy failures in patients with low ser-um anti-Müllerian hormone(AMH)level after in vitro fertilization(IVF)or intracytoplasmic sperm injection(ICSI).Method:The clinical outcome of 1184 cycles in 931 patients with serum AMH<1.1 ng/ml undergoing IVF/ICSI at the Department of Reproductive Medicine of West China Second Hospital,Sichuan University between January 1,2020 and December 31,2020,was retrospectively studied.In total,503 patients(525 cycles)underwent embryo transfer,including clinical pregnant group in 193 patients(193 cycles)and clinical non-pregnant group in 310 pa-tients(332 cycles).All of the patients were divided into three different groups according to their chronological age(<35,35-<40,40-51 years old)and five different serum AMH levels(<0.06 ng/ml,0.06-<0.20 ng/ml,0.20-<0.50 ng/ml,0.50-<0.80 ng/ml,0.80-<1.10 ng/ml),to explore the relationship with IVF pregnancy outcomes.Multivariate Logistic regression analysis was carried out to explore factors affecting pregnancy out-comes afer IVF/ICSI.Results:①Compared with the clinical pregnancy group,the clinical non-pregnant patients were older,AMH level and antral follicle count(AFC)were lower,the number of MII,2PN,available embryos and top quality embryos were also lower,and endometrial thickness at oocyte pickup(OPU)was thinner,and differ-ences above were statistically significant(P<0.05).②AMH level,AFC,BMI,total Gn and MII number were signifi-cantly different among different age groups(P<0.05).The clinical pregnancy rate per transplantation cycle,per oocyte pickup cycle and per ovulation induction cycle also had statistically significant differences(P<0.001),and the pregnancy rate showed a decreasing trend with the increase of age.③There were significant differences in clinical pregnancy rate per transplantation cycle,per oocyte pickup cycle and per ovulation induction cycle among different ranges of low level AMH(P<0.05).④Multivariable Logistic regression analysis confirmed that the prob-ability of pregnancy in patients with low AMH level after transfering embryo was significantly affected by patients'age(P=0.002).Receiver operating characteristic(ROC)curve showed that the best cut-off value for predicting clinical pregnancy was 35.5 years,the area under the curve(AUC)was 0.634(95%CI 0.586-0.682,P<0.001).Conclusions:Patients with low AMH level(<1.1 ng/ml)still have a good chance of pregnancy after IVF/ICSI treatment,and the most notable influencing factor is the patient's chronological age,rather than AMH.When the actual age of patients is less than 35.5 years,the clinical pregnancy outcome after transferring embryo is better e-ven with low AMH level.
9.The Analysis of Influencing Factors of Pregnancy Failure of IVF/ICSI in Pa-tients with Low Serum AMH Level
Lan LIU ; Ying ZHANG ; Yanru ZENG ; Qi CAO ; Tian TANG
Journal of Practical Obstetrics and Gynecology 2024;40(11):933-939
Objective:The study aimed to investigate the factors of pregnancy failures in patients with low ser-um anti-Müllerian hormone(AMH)level after in vitro fertilization(IVF)or intracytoplasmic sperm injection(ICSI).Method:The clinical outcome of 1184 cycles in 931 patients with serum AMH<1.1 ng/ml undergoing IVF/ICSI at the Department of Reproductive Medicine of West China Second Hospital,Sichuan University between January 1,2020 and December 31,2020,was retrospectively studied.In total,503 patients(525 cycles)underwent embryo transfer,including clinical pregnant group in 193 patients(193 cycles)and clinical non-pregnant group in 310 pa-tients(332 cycles).All of the patients were divided into three different groups according to their chronological age(<35,35-<40,40-51 years old)and five different serum AMH levels(<0.06 ng/ml,0.06-<0.20 ng/ml,0.20-<0.50 ng/ml,0.50-<0.80 ng/ml,0.80-<1.10 ng/ml),to explore the relationship with IVF pregnancy outcomes.Multivariate Logistic regression analysis was carried out to explore factors affecting pregnancy out-comes afer IVF/ICSI.Results:①Compared with the clinical pregnancy group,the clinical non-pregnant patients were older,AMH level and antral follicle count(AFC)were lower,the number of MII,2PN,available embryos and top quality embryos were also lower,and endometrial thickness at oocyte pickup(OPU)was thinner,and differ-ences above were statistically significant(P<0.05).②AMH level,AFC,BMI,total Gn and MII number were signifi-cantly different among different age groups(P<0.05).The clinical pregnancy rate per transplantation cycle,per oocyte pickup cycle and per ovulation induction cycle also had statistically significant differences(P<0.001),and the pregnancy rate showed a decreasing trend with the increase of age.③There were significant differences in clinical pregnancy rate per transplantation cycle,per oocyte pickup cycle and per ovulation induction cycle among different ranges of low level AMH(P<0.05).④Multivariable Logistic regression analysis confirmed that the prob-ability of pregnancy in patients with low AMH level after transfering embryo was significantly affected by patients'age(P=0.002).Receiver operating characteristic(ROC)curve showed that the best cut-off value for predicting clinical pregnancy was 35.5 years,the area under the curve(AUC)was 0.634(95%CI 0.586-0.682,P<0.001).Conclusions:Patients with low AMH level(<1.1 ng/ml)still have a good chance of pregnancy after IVF/ICSI treatment,and the most notable influencing factor is the patient's chronological age,rather than AMH.When the actual age of patients is less than 35.5 years,the clinical pregnancy outcome after transferring embryo is better e-ven with low AMH level.
10.The Analysis of Influencing Factors of Pregnancy Failure of IVF/ICSI in Pa-tients with Low Serum AMH Level
Lan LIU ; Ying ZHANG ; Yanru ZENG ; Qi CAO ; Tian TANG
Journal of Practical Obstetrics and Gynecology 2024;40(11):933-939
Objective:The study aimed to investigate the factors of pregnancy failures in patients with low ser-um anti-Müllerian hormone(AMH)level after in vitro fertilization(IVF)or intracytoplasmic sperm injection(ICSI).Method:The clinical outcome of 1184 cycles in 931 patients with serum AMH<1.1 ng/ml undergoing IVF/ICSI at the Department of Reproductive Medicine of West China Second Hospital,Sichuan University between January 1,2020 and December 31,2020,was retrospectively studied.In total,503 patients(525 cycles)underwent embryo transfer,including clinical pregnant group in 193 patients(193 cycles)and clinical non-pregnant group in 310 pa-tients(332 cycles).All of the patients were divided into three different groups according to their chronological age(<35,35-<40,40-51 years old)and five different serum AMH levels(<0.06 ng/ml,0.06-<0.20 ng/ml,0.20-<0.50 ng/ml,0.50-<0.80 ng/ml,0.80-<1.10 ng/ml),to explore the relationship with IVF pregnancy outcomes.Multivariate Logistic regression analysis was carried out to explore factors affecting pregnancy out-comes afer IVF/ICSI.Results:①Compared with the clinical pregnancy group,the clinical non-pregnant patients were older,AMH level and antral follicle count(AFC)were lower,the number of MII,2PN,available embryos and top quality embryos were also lower,and endometrial thickness at oocyte pickup(OPU)was thinner,and differ-ences above were statistically significant(P<0.05).②AMH level,AFC,BMI,total Gn and MII number were signifi-cantly different among different age groups(P<0.05).The clinical pregnancy rate per transplantation cycle,per oocyte pickup cycle and per ovulation induction cycle also had statistically significant differences(P<0.001),and the pregnancy rate showed a decreasing trend with the increase of age.③There were significant differences in clinical pregnancy rate per transplantation cycle,per oocyte pickup cycle and per ovulation induction cycle among different ranges of low level AMH(P<0.05).④Multivariable Logistic regression analysis confirmed that the prob-ability of pregnancy in patients with low AMH level after transfering embryo was significantly affected by patients'age(P=0.002).Receiver operating characteristic(ROC)curve showed that the best cut-off value for predicting clinical pregnancy was 35.5 years,the area under the curve(AUC)was 0.634(95%CI 0.586-0.682,P<0.001).Conclusions:Patients with low AMH level(<1.1 ng/ml)still have a good chance of pregnancy after IVF/ICSI treatment,and the most notable influencing factor is the patient's chronological age,rather than AMH.When the actual age of patients is less than 35.5 years,the clinical pregnancy outcome after transferring embryo is better e-ven with low AMH level.

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