Comparison of the outcomes of ART treatment between patients < 36 and ≥ 36 years of age with low serum AMH levels

Abstract

Objective: To compare the outcomes of ART treatment between women < 36 years and ≥ 36 years of age with low serum AMH levels.

Material and Method: Patients who underwent intracytoplasmic sperm injection (ICSI) treatment with low AMH levels at our infertility clinic were enrolled into the study, retrospectively. Patients were divided into two groups as <36 years and ≥ 36 years of age. The outcomes of ART treatment were compared between two groups.

Results: The total numbers of embryos were found significantly higher in women < 36 years of age than in women ≥ 36 years of age with low AMH levels. The total number of top quality embryos on day 1 was lower in women ≥ 36 years of age than in women < 36 years of age and the difference between two groups showed statistically significance. The biochemical, clinical, and ongoing pregnancy rates of women < 36 years of age were higher than women ≥ 36 years of age; however only the ongoing pregnancy rate showed statistical significant difference. The cycle cancellation rates of women < 36 years and women ≥ 36 years of age were 1.7% and 15.2%, respectively and the difference was found as statistically significant.

Conclusion: The higher ongoing pregnancy rates and embryo quality in younger women is an important outcome to encourage the young women with low serum AMH levels for ART treatment option. Age should take into account in the management and information of women with low AMH level in terms of pregnancy rates and characteristics of ART treatment particularly cycle cancellation rates.

Keywords

• assisted reproduction techniques
• anti-Müllerian hormone
• age

Serum AMH düzeyleri düşük olan < 36 ve ≥ 36 yaş hastaların YÜT sonuçlarının karşılaştırılması

Öz

Amaç: Serum anti-Müllerian hormon (AMH) düzeyleri düşük olan ve yardımcı üreme teknikleri (YÜT) ile tedavi edilen < 36 ve ≥ 36 yaş hastaların sonuçlarının karşılaştırılması.

Gereç ve Yöntem: Bu çalışmada, kliniğimizde serum AMH düzeyleri düşük olan ve intrasitoplazmik sperm enjeksiyon tedavisi uygulanan hastalar çalışmaya dahil edildi. Hastalar  < 36 ve ≥ 36 yaş olmak üzere iki gruba ayrıldı. YÜT tedavi sonuçları iki grup arasında karşılaştırıldı.

Bulgular: Total embryo sayısının; < 36 yaş hasta grubunda ≥ 36 yaş hasta grubuna göre istatistiksel olarak daha yüksek olduğu saptandı. 1.gün iyi kalite embryo sayısı, ≥ 36 yaş hasta grubunda < 36 yaş hasta grubuna göre anlamlı olarak daha düşük bulundu. Biyokimyasal, klinik ve devam eden gebelik oranları < 36 yaş hasta grubunda, ≥ 36 yaş hasta grubuna göre daha yüksekti; ancak sadece devam eden gebelik oranı iki grup arasında anlamlı farklılık gösterdi. Siklus iptal oranı; < 36 yaş hasta grubunda %1.7 iken ≥ 36 yaş hasta grubunda %15.2 olarak tespit edildi ve iki grup arasındaki fark istatistiksel olarak anlamlı bulundu.

Sonuç: Serum AMH düzeyi düşük olan genç hasta grubunda devam eden gebelik oranı ve embryo kalitesinin daha yüksek bulunması; bu hasta grubunun invitro fertilizasyon (IVF) tedavisine yönlendirilmelerini desteklemektedir. Yaş, serum AMH düzeyi düşük olan hastaların bilgilendirilmesinde ve yönetiminde IVF tedavi sonuçları ve özellikle siklus iptal oranları açısından dikkate alınmalıdır.

Anahtar Kelimeler

• yardımcı üreme teknikleri
• anti-Müllerian hormon
• yaş

Kaynakça

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