Research On The Relationship Between Anti-mullerian Hormone Levels In Serum And Follicular Fluid With The Pregnancy Outcomes In Vitro Fertilization And Embryo Transfer

Objective To investigate the relationship between serum and follicular fluid AMH levels and clinical and laboratory indexes by detecting the serum and follicular fluid AMH levels in IVF/ICSI-ET cycle,to clarify the predictive value of AMH levels on IVF-ET outcomes,to guide to formulate individualized treatment plan for patients,and to provide theoretical basis for improving embryo utilization rate and clinical pregnancy outcomes.Methods 264 infertile patients who underwent IVF/ICSI-ET assisted pregnancy from October2018 to March 2019 were collected.All patients were from reproductive medicine center of General Hospital of Ningxia Medical University.The AMH levels in serum and follicular fluid on the day of ovum collection were measured.According to the pregnancy outcomes,they were divided into pregnancy group(145 cycles)and non pregnancy group(119 cycles).According to the AMH levels of serum/follicular fluid,the patients were divided into high-level group(132 cycles)and low-level group(132 cycles).The AMH levels of follicular fluid/serum,the number of oocytes obtained,the rate of MII oocytes,the rate of fertilization,the rate of transplantable embryos,the rate of high-quality embryos and clinical pregnancy were compared between the two groups.SPSS 22.0 software was used for statistics,and the measurement data were expressed by mean±standard deviation(±S).Independent sample t test was used for comparison between the two groups;The?~2 test was used for comparison between groups;The correlation analysis was conducted by two-sided Pearson correlation coefficient;ROC analysis was conducted for each indicator to evaluate its prediction efficiency.P<0.05 was statistically significant.Results(1)The serum AMH levels of pregnancy group was significantly higher than that of non pregnancy group(P<0.05.(2)The serum/follicular fluid AMH,the number of oocytes obtained,the number of MII oocytes,the rate of transplantable embryos and the rate of high-quality embryos in pregnancy group were significantly higher than those in non pregnancy group(P<0.05).(3)The rate of transplantable embryos and the rate of high-quality embryos in the group with high level of follicular fluid AMH were significantly higher than that in the group with low level(P<0.01);(4)The correlation analysis within the group showed that there was a positive correlation between the AMH value of serum and the number of oocytes obtained(P<0.05),and there was a significant positive correlation between the AMH level of follicular fluid and the rate of transplantable embryos in the two groups(P<0.01).(5)The ROC-AUC of serum/follicular fluid AMH was higher than the reference value(P<0.01).Conclusion(1)The serum AMH levels can be used as an important reference for the selection of ovulation induction program.(2)The serum AMH levels can be used as a reference to guide the clinical cancellation of fresh cycle transfer.(3)The AMH levels of follicular fluid can be used as one of the indicators to predict the pregnancy outcome of IVF/ICSI-ET.