METHODS: A total of 258 women (age range: 35-45 years old) who underwent pre-pregnancy examination in our hospital were collected as the research group (RG), among whom 184 were treated with in vitro fertilization-embryo transfer (IVF-ET). Concurrently, 126 women aged 24-30 years who came to our hospital for pre-pregnancy examination were enrolled as the control group (CG). AMH and FORT were detected and compared between the two groups to analyze the clinical significance of the two in women of late reproductive age.
RESULTS: Compared with the CG, AMH was decreased statistically in the RG (P<0.05). AMH was statistically higher in the regular menstrual group than in the menstrual disorder group (P<0.05), and FORT was statistically higher in the pregnancy group in comparison with the non-pregnancy group (P<0.05). AMH decreased with age (P<0.05), while FORT did not correlate with any notable difference among the three subgroups (P>0.05). High, medium and low AMH groups showed no significant difference in the number of retrieved oocytes and transplantable embryos, as well as FORT (P<0.05). A lower AMH level, was correlated with fewer number of retrieved oocytes and transplantable embryos, and higher the FORT level. Significant differences were present among the high, middle and low FORT groups regarding the number of retrieved oocytes and transplantable embryos, the clinical pregnancy rate and AMH level (P<0.05). The lower the level of FORT was, the less the number of retrieved oocytes and transplantable embryos was, the lower clinical pregnancy rate was, and the higher the AMH level was.
CONCLUSIONS: AMH decreases gradually in women with an increase of age, and FORT can effectively predict pregnancy outcome. AMH detection combined FORT is of great significance in predicting the ovarian reserve function in women of late reproductive age.
方法:收集在我院进行孕前检查的258例妇女(年龄范围:35-45岁)作为研究组(RG)。其中184例接受了体外受精-胚胎移植(IVF-ET)治疗。同时,选择来我院进行孕前检查的126例24~30岁妇女作为对照组(CG)。对两组患者进行AMH和FORT检测并比较,分析二者在育龄后期妇女中的临床意义。
结果:与CG相比,RG中AMH显著下降(P<0.05)。正常月经组AMH高于月经紊乱组(P<0.05),妊娠组FORT高于非妊娠组(P<0.05)。AMH随年龄增长而降低(P<0.05),而FORT与三个亚组之间没有任何显着差异(P>0.05)。High,中、低AMH组的卵母细胞数量和可移植胚胎数量无显著差异,以及FORT(P<0.05)。较低的AMH水平,与较少数量的回收卵母细胞和可移植胚胎相关,更高的FORT级别。高之间存在显著差异,关于回收卵母细胞和可移植胚胎数量的中低FORT组,临床妊娠率及AMH水平(P<0.05)。FORT的等级越低,回收的卵母细胞和可移植胚胎的数量越少,较低的临床妊娠率,AMH水平越高。
结论:随着年龄的增长,AMH逐渐降低,FORT能有效预测妊娠结局。AMH检测联合FORT对预测晚育女性卵巢储备功能具有重要意义。