摘要： 目的 研究高水平抗米勒管激素（AMH）对多囊卵巢综合征（PCOS）患者在冻融胚胎移植（FET）周期妊娠结局的影响。方法 收集2019年1月至2021年6月于我院行FET的PCOS患者临床资料，根据AMH水平分组，Ⅰ组108例，AMH中位水平为6.12 ng/mL；Ⅱ组72例，AMH中位水平为8.12 ng/mL。比较2组各项临床检测指标及妊娠期并发症、妊娠结局等情况。结果 2组患者年龄，体质量指数，血清基础卵泡刺激素、促黄体生成素，孕前基础疾病（高血压、糖尿病），不孕因素（不孕时间、男方因素、子宫内膜异位症和输卵管因素）及FET周期指标（取卵周期的获卵数量、移植卵裂期胚胎占比、移植第5天或第6天囊胚占比）差异均无统计学意义（均P > 0.05）。Ⅰ组、Ⅱ组血清基础雌激素分别为（47.89±12.59） pmol/L、（54.70±7.65） pmol/L，2组比较差异有统计学意义（P < 0.05）。Ⅰ组、Ⅱ组患者早产发生率分别为13.89%、50.00%，2组比较差异有统计学意义（P < 0.05）。2组妊娠晚期并发症（前置胎盘、胎盘早剥、子痫前期、胎膜早破、妊娠期糖尿病、羊水过多、羊水过少）发生率比较差异无统计学意义（均P > 0.05）。结论 高水平AMH可能有增加PCOS患者FET周期早产的风险，此类患者妊娠期间要加强随访。

高水平抗米勒管激素对多囊卵巢综合征患者冻融胚胎移植周期妊娠结局的影响

孙凯旋, 修银玲, 陆晓黎, 于月新

北部战区总医院生殖医学科, 沈阳 110016

收稿日期:2022-12-11出版日期:2023-11-30发布日期:2023-11-07
通讯作者:于月新E-mail:yuyuexinpingan@163.com
作者简介:孙凯旋(1990-),女,主治医师,硕士.
基金资助:辽宁省科学技术计划（2020JH2/10300118）


关键词: 多囊卵巢综合征, 冻融胚胎移植, 抗米勒管激素, 妊娠结局
Abstract: Objective To study the effect of high levels of anti-Müllerian hormone (AMH) on pregnancy outcome in patients with poly-cystic ovary syndrome (PCOS) during frozen-thaw embryo transfer (FET) cycles. Methods The clinical data of PCOS patients who underwent FET in our hospital from January 2019 to June 2021 were collected and grouped according to AMH levels, with 108 patients in groupⅠwith a median AMH level of 6.12 ng/mL; and 72 patients in groupⅡwith a median AMH level of 8.12 ng/mL. All the clinical test indicators, pregnancy complications, and pregnancy outcomes between the two groups were compared. Results There were no statistically significant differences in age, body mass index, serum basal follicle-stimulating hormone, luteinizing hormone, pre-pregnancy underlying diseases (hypertension, diabetes mellitus), infertility factors (duration of infertility, male factor, endometriosis, and tubal factor), and indicators of the FET cycle (the number of eggs acquired during the cycle of egg retrieval, percentage of embryos transferred at cleavage stage, the percentage of blastocysts on day 5 or day 6 of the transfer) in the two groups (all P > 0.05). The serum basal estrogen was 47.89±12.59 pmol/L and 54.70±7.65 pmol/L in groupⅠand groupⅡ, respectively, and the difference between the two groups was statistically significant (P < 0.05). The incidence of preterm labor in patients in groupⅠand groupⅡwas 13.89% and 50.00%, respectively, and the difference between the two groups was statistically significant (P < 0.05). There was no statistically significant difference in the comparison of the incidence of late pregnancy complications (placenta praevia, placental abruption, preeclampsia, premature rupture of the membranes, gestational diabetes mellitus, excess amniotic fluid, and amniotic fluid) between the two groups (all P > 0.05). Conclusion High levels of AMH may result in an increased risk of preterm labor in FET cycles in patients with PCOS. Such patients should, therefore, be followed up intensively during pregnancy.
Key words: polycystic ovary syndrome, frozen-thaw embryo transfer, anti-Müllerian hormone, pregnancy outcome
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