Abstract：
OBJECTIVE: To evaluate the predictive value of serum AMH for clinical pregnancy in non-infertile population undergoing intrauterine insemination with donor sperm (ds-IUI).
METHODS: This multicenter prospective study (ClinicalTrials.gov ID: NCT06263192) recruited all non-infertile women undergoing ds-IUI from June 2020 to December 2022 in three different fertility clinics in Spain and Chile. Indications for ds-IUI included severe oligoasthenoteratozoospermia, female partner, or single status. Clinical pregnancy rates were compared between women with AMH ≥ 1.1 and < 1.1 ng/mL. The main outcome measure was the cumulative clinical pregnancy rate after up to 4 ds-IUI cycles.
RESULTS: A total of 458 ds-IUI cycles were performed among 245 patients, of whom 108 (44.08%) achieved clinical pregnancy within 4 cycles, 60.2% of these occurring in the first attempt and 84.2% after two attempts. We found no significant differences in AMH levels or other parameters (such as age, BMI, FSH, AFC) between women who became pregnant and those who did not. Cumulative pregnancy rates and logistic regression analysis revealed that AMH ≥ 1.1 ng/mL was not predictive of ds-IUI success. While a high positive correlation was observed between AFC and AMH (r = 0.67, p < 0.001), ROC curve analyses indicated that neither of these ovarian reserve markers accurately forecasts cumulative ds-IUI outcomes in non-infertile women.
CONCLUSIONS: The findings of this multicenter study suggest that AMH is not a reliable predictor of pregnancy in non-infertile women undergoing ds-IUI. Even women with low AMH levels can achieve successful pregnancy outcomes, supporting the notion that diminished ovarian reserve should not restrict access to ds-IUI treatments in eligible non-infertile women.
METHODS: This multicenter prospective study (ClinicalTrials.gov ID: NCT06263192) recruited all non-infertile women undergoing ds-IUI from June 2020 to December 2022 in three different fertility clinics in Spain and Chile. Indications for ds-IUI included severe oligoasthenoteratozoospermia, female partner, or single status. Clinical pregnancy rates were compared between women with AMH ≥ 1.1 and < 1.1 ng/mL. The main outcome measure was the cumulative clinical pregnancy rate after up to 4 ds-IUI cycles.
RESULTS: A total of 458 ds-IUI cycles were performed among 245 patients, of whom 108 (44.08%) achieved clinical pregnancy within 4 cycles, 60.2% of these occurring in the first attempt and 84.2% after two attempts. We found no significant differences in AMH levels or other parameters (such as age, BMI, FSH, AFC) between women who became pregnant and those who did not. Cumulative pregnancy rates and logistic regression analysis revealed that AMH ≥ 1.1 ng/mL was not predictive of ds-IUI success. While a high positive correlation was observed between AFC and AMH (r = 0.67, p < 0.001), ROC curve analyses indicated that neither of these ovarian reserve markers accurately forecasts cumulative ds-IUI outcomes in non-infertile women.
CONCLUSIONS: The findings of this multicenter study suggest that AMH is not a reliable predictor of pregnancy in non-infertile women undergoing ds-IUI. Even women with low AMH levels can achieve successful pregnancy outcomes, supporting the notion that diminished ovarian reserve should not restrict access to ds-IUI treatments in eligible non-infertile women.
摘要：
目的：评价血清AMH水平对非不孕患者宫腔内供精人工授精(ds-IUI)临床妊娠的预测价值。
方法：这项多中心前瞻性研究（ClinicalTrials.govID：NCT06263192）招募了2020年6月至2022年12月在西班牙和智利的三个不同生育诊所接受ds-IUI的所有非不育妇女。ds-IUI的适应症包括严重的少弱精子症，女性伴侣,或单一状态。比较AMH≥1.1和<1.1ng/mL妇女的临床妊娠率。主要结局指标是多达4个ds-IUI周期后的累积临床妊娠率。
结果：245例患者共进行了458个ds-IUI周期，其中108人（44.08%）在4个周期内实现临床妊娠，其中60.2%发生在第一次尝试中，84.2%发生在两次尝试后。我们发现AMH水平或其他参数(如年龄，BMI,FSH,AFC）在怀孕的妇女和未怀孕的妇女之间。累积妊娠率和逻辑回归分析显示，AMH≥1.1ng/mL不能预测ds-IUI的成功。AFC与AMH呈高度正相关(r=0.67,p<0.001),ROC曲线分析表明，这些卵巢储备标志物均不能准确预测非不育妇女的累积ds-IUI结局。
结论：这项多中心研究的结果表明，在接受ds-IUI的非不孕妇女中，AMH并不是妊娠的可靠预测指标。即使AMH水平较低的女性也可以成功怀孕，支持卵巢储备减少不应限制符合条件的非不孕妇女接受ds-IUI治疗的观点.
方法：这项多中心前瞻性研究（ClinicalTrials.govID：NCT06263192）招募了2020年6月至2022年12月在西班牙和智利的三个不同生育诊所接受ds-IUI的所有非不育妇女。ds-IUI的适应症包括严重的少弱精子症，女性伴侣,或单一状态。比较AMH≥1.1和<1.1ng/mL妇女的临床妊娠率。主要结局指标是多达4个ds-IUI周期后的累积临床妊娠率。
结果：245例患者共进行了458个ds-IUI周期，其中108人（44.08%）在4个周期内实现临床妊娠，其中60.2%发生在第一次尝试中，84.2%发生在两次尝试后。我们发现AMH水平或其他参数(如年龄，BMI,FSH,AFC）在怀孕的妇女和未怀孕的妇女之间。累积妊娠率和逻辑回归分析显示，AMH≥1.1ng/mL不能预测ds-IUI的成功。AFC与AMH呈高度正相关(r=0.67,p<0.001),ROC曲线分析表明，这些卵巢储备标志物均不能准确预测非不育妇女的累积ds-IUI结局。
结论：这项多中心研究的结果表明，在接受ds-IUI的非不孕妇女中，AMH并不是妊娠的可靠预测指标。即使AMH水平较低的女性也可以成功怀孕，支持卵巢储备减少不应限制符合条件的非不孕妇女接受ds-IUI治疗的观点.
