婦女AMH極低的活產機會
翻自權威的生殖期刊HUMAN REPRODUCTION
2011.04.30
奧地利的研究
婦女AMH極低的活產機會
摘要
背景:
研究婦女極低的AMH（<0.1-0.4 ng/ml）在人工生殖的治療後活產的能力與這樣的能力是否與年齡有關。
方法:
2006年1月至2009年10月連續 128例AMH ≤0.4 ng/ml的患者接受IVF治療進行回顧性的研究懷孕率和活產的機會。
結果:
患者提出了在平均（±標準差）年齡為 40.8 ± 4.1歲，平均（±標準差）FSH為15.7 ± 11.1 mIU / ml，且平均（±標準差）AMH為 0.2 ± 0.1 ng/ml。一百二十名婦女進行了總共接受了254個IVF週期。共20個IVF週期有臨床懷孕（7.9％每週期的開始 [95％可信區間（CI）：4.9-11.9％]; 15.6％的累積 [區間：9.8-23.1％]）。20個婦女驗孕成功(clinical pregnancy)，有12名懷孕婦女（即11個單胞胎和一對雙胞胎）共產下13個活產嬰兒和8例懷孕婦女流產。8位生產是第一個IVF週期（每週期開始 6.3％）和4個生產在隨後的IVF週期（3.2％）。依女性的年齡計算，70名婦女≤42歲共有16個臨床妊娠懷孕，而其中10例（14.3％）活產，而58例>42歲有4個臨床懷孕，其中2例活產（3.4％），相較於小於42歲的族群顯著減少懷孕的機會（P = 0.013）和生產率（P = 0.036）。
結論:
極低的AMH，中等但合理的懷孕率和活產率仍然是可能的。極低的AMH並不能代表唯一的指標而暫緩生育治療。
原文
Hum Reprod. 2011 Apr 30.
Live birth chances in women with extremely low-serum anti-Mullerian hormone levels.
Weghofer A, Dietrich W, Barad DH, Gleicher N.
Source
Department of Obstetrics and Gynecology, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
Abstract
BACKGROUND To determine whether women with extremely low-serum anti-Mullerian hormone (AMH) levels (<0.1-0.4 ng/ml) still demonstrate live birth potential with assisted reproduction and whether such potential is age dependent. METHODS Between January 2006 and October 2009, 128 consecutive infertility patients with AMH ≤0.4 ng/ml were retrospectively evaluated for pregnancy chances and live birth rates after IVF. RESULTS Patients presented at a mean (±SD) age of 40.8 ± 4.1 years, with mean (±SD) baseline FSH of 15.7 ± 11.1 mIU/ml and mean (±SD) AMH of 0.2 ± 0.1 ng/ml. One hundred and twenty-eight women underwent a total of 254 IVF cycles. Twenty clinical pregnancies were recorded (7.9% per cycle start [95% confidence interval (CI): 4.9-11.9%]; 15.6% cumulative [CI: 9.8-23.1%]). These pregnancies resulted in 13 live births in 12 women (i.e. 11 singletons and a pair of twins) and 8 patients miscarried. Eight deliveries occurred after the first cycle (6.3% per cycle start) and four after subsequent IVF cycles (3.2%). When evaluated according to female age, 70 women ≤42 years presented with 16 clinical pregnancies that resulted in 10 deliveries (14.3%), while 58 patients >42 years presented with four clinical pregnancies that resulted in 2 deliveries (3.4%), representing a reduced pregnancy chance (P = 0.013) and delivery rate (P = 0.036) versus age ≤42 years. CONCLUSIONS With extremely low-serum AMH levels, moderate, but reasonable pregnancy and live birth rates are still possible. Extremely low AMH levels do not seem to represent an appropriate marker for withholding fertility treatment.
