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Federación Mexicana de Ginecología y Obstetricia, A.C.

2022, Número 02

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Ginecol Obstet Mex 2022; 90 (02)


Respuesta ovárica y tasa de nacido vivo en pacientes con cuenta folicular antral y hormona antimülleriana alteradas en ciclos de reproducción asistida

Fernández del Campo-Audelo M, Barros-Delgadillo JC, Muñoz-Manrique C

Idioma: Español
Referencias bibliográficas: 31
Paginas: 119-133
Archivo PDF: 193.43 Kb.


RESUMEN

Objetivo: Evaluar la relación entre la cuenta folicular antral y la hormona antimülleriana con la cantidad de ovocitos recuperados y la tasa de nacido vivo.
Materiales y Métodos: Estudio retrospectivo, observacional, descriptivo y comparativo efectuado en pacientes atendidas en un hospital de tercer nivel. Parámetros de estudio: ciclos FIVTE-ICSI practicados entre enero de 2017 y marzo de 2021. Los ciclos, para fines de estudio, se dividieron en tres grupos: 1) cuenta folicular antral, 2) hormona antimülleriana y 3) ambos parámetros alterados. Para evaluar la relación de los marcadores con la cantidad de ovocitos recuperados y la tasa de nacido vivo se llevó a cabo un análisis estadístico exploratorio. Entre los tres grupos se compararon las características sociodemográficas y clínicas mediante las pruebas de Kruskal-Wallis y χ2, para variables continuas y categóricas, respectivamente. Se consideró significativo un nivel menor de 0.50; se utilizó el programa estadístico STATA 12.
Resultados: Entre los tres grupos analizados se incluyeron 222 ciclos: con cuenta folicular antral, hormona antimülleriana o ambos alterados. Se encontraron 54 (24.3%) con un nacido vivo. La cantidad de folículos antrales y la tasa de nacido vivo fueron significativamente menores en las pacientes con ambos marcadores alterados. Las pacientes con concentraciones alteradas de hormona antimülleriana tuvieron mejor pronóstico (RM 2.3; IC95%: 1.08-4.93, p ‹ 0.03). La dosis de FSH y la cantidad de embriones transferidos fueron las variables que influyeron en la probabilidad de tener un recién nacido vivo.
Conclusiones: La concentración de hormona antimülleriana menor de 1.2 ng/mL se relaciona con mejor respuesta ovárica y mayor tasa de nacido vivo. Esta mayor probabilidad está influida por la cantidad de gonadotropinas utilizada y de embriones transferidos.


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