Does AMH correlate with oocyte quality obtained from donors
FERTILITY AND STERILITY(2018)
摘要
AMH levels have been used as reliable indicators for ovarian response to gonadotropins, and it has been shown to be closely associated with oocyte yield and to some extent with clinical outcomes in human IVF treatment cycles. However, it remains controversial whether AMH is associated not only with oocyte quantity but possibly also with oocyte quality. To compare cycle outcomes from cycles with variable oocyte numbers, we looked at recipient cycles using cryo-banked warmed oocytes from two groups of oocyte donors; those with AMH levels below 5ng/ml and those with an AMH greater than 5 where 5 represented the median AMH value for the data set. Once segregated around the median AMH value, we compared outcomes for multiple parameters as a function of AMH. Retrospective study. Oocyte donors recruited for our donor egg bank were required to have an AMH of at least 2.0ng/ml and a basal antral follicle count of at least 20 (donors with PCOS and with other conditions not fulfilling the established requirements were excluded). All donors were treated with rFSH/GnRH antagonist and using GnRH agonist as trigger, with transvaginal egg collection occurring 36 hours after the trigger injection. Cryopreservation of donor oocytes derived from 274 oocyte retrievals was performed using minimum volume vitrification. Oocytes were warmed for each matched recipient independently (402 recipient cycles, total of 2707 oocytes warmed). Outcome data was grouped by serum AMH level; I) <5 ng/ml, II) ≥5 ng/ml. Outcome parameters were analyzed by Chi-square. There were no cases of OHSS among the donors. All other variables, including semen parameters were similar in both groups. Tabled 1AMH<5AMH>=5p valueTotal # of retrieval cycle for donation138136-AMH (mean±SD)(ng/ml)3.37±2.947.86±3.27p<0.05# of retrieved follicle (mean±SD)31.74±4.9540.89±15.67p<0.05Total # of recipient cycle200202-Total # of oocyte warmed (mean±SD)1327(6.64±1.70)1380(6.83±1.75)NSTotal # of oocyte survived (%)1247(93.97)1295(93.84)NSTotal # of oocyte fertilized (%)1029(77.50)1032(74.78)NSTotal # of blastocyst (d5/6) (%)744(56.06)697(50.50)p<0.05Total # of ET (mean±SD)222(1.11±0.31)229(1.13±0.34)NSTotal # of implantation (%)134(60.36)122(53.27)NSTotal # of clinical pregnancy (%)122(61.00)108(53.46)NS Open table in a new tab Our results demonstrate that oocyte yield is strongly correlating with AMH levels in oocyte donors. Survival and fertilization rates after warming were not significantly different between low and high AMH groups. Similarly, pregnancy and implantation rates were not significantly different between groups. It is noteworthy that the blastocyst conversion rate was slightly (but statistically significant) lower when the donors’ AMH level was equal to and/or above 5 ng/ml. Our findings imply that AMH can be a good indicator for oocyte yield in oocyte donors. All laboratory and clinical outcomes were similar between low and high AMH groups except for the blastulation rate, which warrants further study.
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关键词
oocyte quality,donors,amh
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