Evaluation of Predictive Value of Artificial Insemination in Anti-Mullerian Hormone in Patients with Polycystic Ovary Syndrome / 中山大学学报(医学科学版)

ABSTRACT

@#【Objective】To evaluate the role of serum antimullerian hormone （AMH） concentration in predicting clinical outcomes in controlled ovarian stimulation and intrauterine insemination （IUI）. 【Methods】 A retrospective analysis of IUI data from patients with polycystic ovary syndrome and infertility in our reproductive center from January 2014 to August 2017. According to the clinical outcomes，data was divided into three groups：clinical pregnancy group，non-pregnant group，and cancellation cycle group due to multiple follicular or no dominant follicular develop. The ovarian function evaluation indexes were compared such as serum AMH，basal FSH and basal sinus follicle（AFC）. The cutoff values of the AMH to predict multi- follicular development or no dominant follicular development which IUI cycles were cancelled，and to predict obtain cumulative clinical pregnancy outcomes were calculated according to the ROC curve to cancel the cycle. 【Results】 The clinical pregnancy rates of PCOS patients were from 15.9% to 17.1% ，while the cumulative clinical pregnancy rate increased in repeat cycles （≤3 cycles） was 21.6% ，significantly higher than the average clinical pregnancy rate（16.7%）during the first cycle. AMH levels in the cancelled cycle group were significantly higher than those in the non-cancelled cycle group［（14.1±6.5）vs（10.3±4.3）ng/mL，（14.1±6.5）vs（9.3±4.3）ng/mL， P<0.025］. Compared with the clinical pregnancy group，cancel cycle group and non- pregnant group，the mean AFC of the former two groups were significantly higher［（34.5±11.4）vs（30.7±11.3），（7.8±10.8）vs（30.7±11.3），P<0.025］. In addition，we found that women′ s age，baseline FSH were negatively correlated with the cumulative pregnancy rate of repeated IUI cycles，and women′s baseline BMI，baseline LH，AFC，and AMH were positively correlated with cumulative pregnancy rates. The number of mature follicles on the HCG triggering day，as well as the value of AMH，may be the influencing factor of IUI cumulative clinical pregnancy. By ROC curve analysis，we assume that AMH is more suitable than the AFC to predict IUI cycle cancellation rate and the cumulative pregnancy rate.【Conclusion】Repeated IUI cycles can be improved cumulative pregnancy rate of PCOS infertile couples. AMH，as an important index to measure ovarian reserve function，can be used to predict the the IUI cumulative clinical pregnancy outcomes and cancelled cycle rates：as AMH increased to more than 6.56 ng/mL，the pregnancy rate increased；but when AMH ≥14.72 ng/mL，the risk of cancelled IUI cycles was increased，becasues of multi-follicular developing and absence of dominant follicle development.