AMH高低與胚胎染色體異常率無明顯關聯

AMH低的病患，染色體異常率並無明顯較高

ANTI-MÜLLERIAN HORMONE IS NOT ASSOCIATED WITH EMBRYO PLOIDY IN PATIENTS WITH AND WITHOUT INFERTILITY UNDERGOING IN VITRO FERTILIZATION WITH PREIMPLANTATION GENETIC TESTING

 2022DOI:https://doi.org/10.1016/j.fertnstert.2022.11.018

Objective

To assess the association between anti-müllerian hormone (AMH) and embryo ploidy rates in two cohorts of patients undergoing in vitro fertilization (IVF) with trophectoderm biopsy for preimplantation genetic testing for aneuploidy (PGT-A): (1) the general population of women pursuing IVF with PGT-A (Infertile cohort) and (2) women pursuing IVF with preimplantation genetic testing for monogenic disorders (PGT-M) due to risk for hereditary monogenic diseases (Non-infertile cohort).

Patients

Patients undergoing their first cycle of IVF with trophectoderm biopsy and PGT-A or PGT-A and PGT-M in our center between 03/2012 and 06/2020. Patients of advanced maternal age according to Bologna criteria (age ≥40) and patients who underwent fresh embryo transfers were excluded.

Main Outcome Measure

Proportion of euploid, mosaic, and aneuploid embryos per cycle.

Results

“Infertile” (n= 926) and “Non-infertile” (n= 214) patients were stratified based on AMH levels, with low AMH defined as <1.1 ng/ml in accordance with the Bologna criteria. Age-adjusted regression models showed no relationship between AMH classification and proportion of euploid, mosaic, and aneuploid embryos in the Infertile or Non-infertile cohorts. In the Infertile cohort, no association between AMH classification and embryo ploidy rates was identified in a subgroup analysis of patients less than 35 years, patients 35-37, and patients 38-39 years old. These findings persisted in a sensitivity analysis of Infertile patients stratified into AMH (ng/ml) quartile categories.

Conclusion

AMH is not associated with proportion of euploid, mosaic, or aneuploid embryos in two large cohorts of patients undergoing IVF with PGT-A (Infertile patients) or PGT-A and PGT-M (Non-infertile patients), suggesting that a quantitative depletion of ovarian reserve does not predict the ploidy status of the embryo cohort.