AMH independently predicts aneuploidy but not live birth per transfer in IVF PGT-A cycles

Reproductive Biology and Endocrinology

Research

David B. Seifer¹  Reshef Tal¹  Howard J. Li¹ 

[1]Dept. of Obstetrics, Gynecology & Reproductive Sciences, Yale School of Medicine, 333 Cedar Street, 06510, New Haven, CT, U.S.A.

关键词: Anti-Mullerian hormone (AMH);    Pre-implantation genetic testing for aneuploidy (PGT-a);    Pre-implantation genetic diagnosis (PGD);    Aneuploidy;    In-vitro fertilization;    Live birth;   

DOI  :  10.1186/s12958-023-01066-w

 received in 2022-12-01, accepted in 2023-01-21,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundWhile anti-Müllerian hormone (AMH) predicts quantitative IVF outcomes such as oocyte yield, it is not certain whether AMH predicts markers of oocyte quality such as aneuploidy.MethodsRetrospective case–control analysis of the SART-CORS database, 2014–2016, to determine whether anti-Müllerian hormone (AMH) predicts aneuploidy and live birth in IVF cycles utilizing preimplantation genetic testing for aneuploidy (PGT-A).ResultsOf 51,273 cycles utilizing PGT-A for all embryos, 10,878 cycles were included in the final analysis; of these, 2,100 cycles resulted in canceled transfer due to lack of normal embryos and 8,778 cycles resulted in primary FET. AMH levels of cycles with ≥ 1 euploid embryo were greater than those of cycles with no normal embryos, stratifying by number of embryos biopsied (1–2, 3–4, 5–6, and ≥ 7), P < 0.017 for each stratum. Adjusting for age and number of embryos biopsied, AMH was a significant independent predictor of ≥ 1 euploid embryo for all age groups: < 35 yrs (aOR 1.074; 95%CI 1.005–1.163), 35–37 years (aOR 1.085; 95%CI 1.018–1.165) and ≥ 38 years (aOR 1.055; 95%CI 1.020–1.093). In comparative model analysis, AMH was superior to age as a predictor of  ≥ 1 euploid embryo for age groups < 35 years and 35–37 years, but not  ≥ 38 years. Across all cycles, age (aOR 0.945, 95% CI 0.935–0.956) and number of embryos (aOR 1.144, 95%CI 1.127–1.162) were associated with live birth per transfer, but AMH was not (aOR 0.995, 95%CI 0.983–1.008). In the subset of cycles resulting in ≥ 1 euploid embryo for transfer, neither age nor AMH were associated with live birth.ConclusionsAdjusting for age and number of embryos biopsied, AMH independently predicted likelihood of obtaining ≥ 1 euploid embryo for transfer in IVF PGT-A cycles. However, neither age nor AMH were predictive of live birth once a euploid embryo was identified by PGT-A for transfer. This analysis suggests a predictive role of AMH for oocyte quality (aneuploidy risk), but not live birth per transfer once a euploid embryo is identified following PGT-A.

【 授权许可】

CC BY   
© The Author(s) 2023

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