{"id":81,"title":"Association of anti-Müllerian hormone and antral follicle count discordance with embryological and pregnancy outcomes in the first IVF/ICSI cycle","title_zh":"抗苗勒管激素与窦卵泡计数不一致与首次IVF/ICSI周期胚胎学及妊娠结局的关联","url":"https://pubmed.ncbi.nlm.nih.gov/42980957","doi":"10.1007/s10815-026-04072-0","pmid":"42980957","journal":"J Assist Reprod Genet","kind":"paper","lang":"en","published_at":"2026-11-04T00:00:00+00:00","fetched_at":"2026-11-08T03:43:53+00:00","authors":["Wu Y","Cai J","Xu M","Yu M","Xu J","Guo D","Chen C","Zhang Y","Pan L","Wang Y","Zhu H","Ji L"],"primary_topic":"art-clinical","topics":[{"slug":"art-clinical","score":12.0,"hits":["embryo transfer","icsi","in vitro fertilization","intracytoplasmic sperm injection","ivf","live birth"]},{"slug":"oocyte","score":8.0,"hits":["antral follicle","oocyte","oocytes","ovarian","ovarian reserve"]},{"slug":"repro-endo","score":5.0,"hits":["amh","anti-müllerian"]},{"slug":"early-pregnancy","score":5.0,"hits":["biochemical pregnancy","pregnancy outcomes"]},{"slug":"early-embryo","score":1.0,"hits":["zygotes"]},{"slug":"male","score":1.0,"hits":["sperm"]}],"topic_score":12.0,"preference_score":5.0,"preference_labels":["可转化到 ART 实验室的发现"],"llm_score":76.0,"final_score":81.0,"score_dims":{"novelty":68,"rigor":82,"impact":72,"relevance":95,"translation":78},"recommend_reason":"大样本（6456例）首次IVF/ICSI队列，量化了AMH与AFC不一致这一临床常见但证据有限的表型对获卵、胚胎产出与活产的独立影响，可直接用于促排方案与预后咨询；但为单中心回顾性设计，机制解释有限。","keywords":["抗苗勒管激素","窦卵泡计数","卵巢储备","IVF/ICSI","卵巢反应","活产率"],"selected":1,"story_id":101,"llm_provider":"deepseek","llm_model":"deepseek-flash","llm_effort":"low","source_key":"pubmed-art","source_name":"PubMed · 辅助生殖临床","source_tier":1,"mention_count":5,"has_interpretation":false,"journal_key":"jarg","journal_tier":"standard","journal_if":3.0,"is_mock":false,"summary_zh":"该回顾性队列纳入2018年1月至2024年1月共6456例首次IVF/ICSI周期患者，按AMH与AFC一致性分为一致正常组、一致减退组及不一致组（占12.64%）。校正后，不一致组的获卵数、MII卵、2PN受精卵、可移植胚胎及优质胚胎数均低于一致正常组（均P<0.001），但与一致减退组无显著差异。在6188例完成首次移植者中，不一致组妊娠结局与一致正常组相当，而生化妊娠与活产几率高于一致减退组；不一致组内AMH正常/AFC减退者获卵与胚胎产出更高。结论提示AMH-AFC不一致者卵巢反应与胚胎产出偏低，但妊娠结局总体相近。","summary":"PURPOSE: To investigate the associations of anti-Müllerian hormone (AMH) and antral follicle count (AFC) concordance/discordance patterns with embryological and pregnancy outcomes among patients undergoing their first in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycle. METHODS: This retrospective cohort study included 6456 patients undergoing their first IVF/ICSI cycle between January 2018 and January 2024. Patients were classified into the concordant normal group (AMH ≥ 1.2 ng/mL and AFC ≥ 5), the concordant reduced group (AMH < 1.2 ng/mL and AFC < 5), and the discordant group (AMH-normal/AFC-reduced: AMH ≥ 1.2 ng/mL with AFC < 5 or AMH-reduced/AFC-normal: AMH < 1.2 ng/mL with AFC ≥ 5). Regression models were used to evaluate their embryological and pregnancy outcomes. RESULTS: Among 6456 patients, 816 (12.64%) exhibited AMH-AFC discordance. Compared with the concordant normal group, the discordant group had lower adjusted numbers of retrieved oocytes (β = - 4.04, 95% CI - 4.44 to - 3.65), MII oocytes (β = - 3.46, 95% CI - 3.83 to - 3.10), 2PN zygotes (β = - 2.57, 95% CI - 2.87 to - 2.26), transferable embryos (β = - 2.23, 95% CI - 2.52 to - 1.95), and high-quality embryos (β = - 1.73, 95% CI - 1.98 to - 1.47) (all P < 0.001). No significant differences in these outcomes remained between the discordant and concordant reduced groups after adjustment. Among the 6188 patients who underwent their first embryo transfer, pregnancy outcomes did not differ significantly between the discordant and concordant normal groups, whereas the discordant group had higher adjusted odds of biochemical pregnancy (OR = 1.38, 95% CI 1.03-1.86, P = 0.031) and live birth (OR = 1.40, 95% CI 1.01-1.95, P = 0.042) than the concordant reduced group. Within the discordant group, the AMH-normal/AFC-reduced subgroup had higher oocyte and embryo yields, but their pregnancy outcomes were comparable. CONCLUSION: AMH-AFC discordance was associated with lower ovarian response and embryo yield than concordant normal ovarian reserve. Among discordant patients, normal AMH with reduced AFC was associated with higher oocyte and embryo yields. The discordant group had modestly higher odds of biochemical pregnancy and live birth than the concordant reduced group, whereas pregnancy outcomes were otherwise broadly comparable across AMH-AFC patterns.","interpretation_basis":null,"fulltext_status":null,"interpretation":null,"fulltext":{"available":false,"status":null,"reason":"尚未抓取全文（未入选、分数未达阈值，或还没跑 fulltext 步骤）","pmcid":null,"license":null,"chars":0,"source":null,"fetched_at":null}}