Abstract：
Early spontaneous abortion (ESA) is a common adverse pregnancy outcome mainly attributed to embryo chromosomal abnormalities. However, as a quantitative marker, whether the anti-Müllerian hormone (AMH) can reflect oocyte quality is still controversial. By integrating biological evidence and adjusting many cofounders, this study aimed to clarify the controversies about the association between AMH and ESA caused by embryo aneuploidy during assisted reproductive technology (ART) treatment. We strictly preselected 988 patients receiving first ART treatment for analyzing clinical data, while 55 of them acquired chorionic villi karyotype results. In addition, 373 biopsied embryos from 126 patients receiving preimplantation genetic diagnosis (PGT) were tracked to compare embryo karyotypes. Univariate and multiple factor regressions were applied to analyze the risk factors leading to ESA. As covariates unadjusted, AMH (odds ratio 0.87, 95% CI 0.82-0.93) was the significant variable contributing to ESA. However, AMH played no significant role in the following regression models after age was adjusted. Also, AMH had no significant association with ESA in most age-adjusted subgroups, except in the male factors engaged subgroup. Additionally, compared to the patients with euploid chorionic villi karyotypes, those with aneuploid karyotypes were older and acquired fewer oocytes, yet their AMH levels were not significantly different. Furthermore, the embryo aneuploidy was independent of AMH while associated with maternal age, retrieved oocyte number, and embryo quality. This study suggested that AMH was unassociated with the ESA caused by embryo aneuploidy in ART therapy. As a critical cofounder, age remains the variable closely related to ESA.
摘要：
早期自然流产（ESA）是一种常见的不良妊娠结局，主要归因于胚胎染色体异常。然而,作为定量标记，抗苗勒管激素(AMH)能否反映卵母细胞质量仍存在争议。通过整合生物学证据并调整许多联合创始人，本研究旨在阐明在辅助生殖技术(ART)治疗期间由胚胎非整倍性引起的AMH与ESA之间的关联的争议.我们严格预选988例接受首次ART治疗的患者，以分析临床数据，其中55例获得了绒毛膜绒毛核型结果。此外,追踪了来自126名接受植入前遗传学诊断（PGT）的患者的373个活检胚胎，以比较胚胎核型。应用单因素和多因素回归分析导致ESA的危险因素。由于协变量未经调整，AMH（比值比0.87，95%CI0.82-0.93）是导致ESA的重要变量。然而,调整年龄后，AMH在以下回归模型中没有显着作用。此外，在大多数年龄调整亚组中，AMH与ESA无显著关联，除了男性因素参与的亚组。此外,与整倍体绒毛核型患者相比，具有非整倍体核型的人年龄较大，获得的卵母细胞较少，然而他们的AMH水平没有显著差异.此外，胚胎非整倍体与AMH无关，但与母亲年龄有关，检索到的卵母细胞数量，和胚胎质量。这项研究表明，在ART治疗中，AMH与胚胎非整倍体引起的ESA无关。作为一个关键的联合创始人，年龄仍然是与欧空局密切相关的变量。
