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目的:探讨抗苗勒管激素（anti-Müllerian hormone，AMH）水平对首次胚胎移植术后早期妊娠丢失结局的影响。方法:采用回顾性队列研究，分析2016年7月至2019年6月期间在河南省人民医院生殖医学中心首次行体外受精/卵胞质内单精子注射（n in vitro fertilization/intracytoplasmic sperm injection，IVF/ICSI）助孕且首次胚胎移植后人绒毛膜促性腺激素（human chorionic gonadotropin，hCG）阳性的3973例患者的临床资料。按照AMH水平等分为四个亚组：A组（AMH≤1.97 μg/L）、B组（1.97 μg/L5.41 μg/L），通过单因素分析、分类多元logistic回归分析、曲线拟合及阈值效应等方法，探讨AMH水平对行IVF/ICSI助孕首次胚胎移植术后早期妊娠丢失结局的影响。n 结果:①纳入总人群的早期妊娠丢失率为15.71%（624/3973）。四组间体质量指数、不孕类型、授精方式差异均无统计学意义（均n P>0.05），AMH水平［（1.21±0.50）μg/L、（2.63±0.38）μg/L、（4.26±0.60）μg/L、（8.26±2.78）μg/L，n P<0.001］、年龄［（32.35±5.00）岁、（30.77±4.24）岁、（29.90±3.96）岁、（29.35±3.85）岁，n P<0.001］、双侧窦卵泡计数（8.01±4.04、11.46±4.40、13.55±4.73、16.08±5.08，n P<0.001）、移植胚胎数［（1.74±0.44）枚、（1.73±0.45）枚、（1.69±0.46）枚、（1.66±0.47）枚，n P<0.001］、移植胚胎发育时间（卵裂期胚胎/囊胚比例）（85.49%/14.51%、76.42%/23.58%、69.55%/30.45%、65.79%/34.21%，n P<0.001）、移植周期类型（新鲜/冻融胚胎移植）（75.08%/24.92%、71.15%/28.85%、57.79%/42.21%、39.46%/60.54%，n P<0.001）及早期妊娠丢失率（22.12%、12.25%、12.76%、15.64%，n P<0.001）差异均有统计学意义。②调整混杂因素后，分类多元logistic回归分析显示，B、C、D三组的早期妊娠丢失率均低于A组，其中总纳入人群中B组（调整后n OR=0.60，95% n CI=0.46~0.79，n P<0.001）、C组（调整后n OR=0.70，95% n CI=0.51~0.97，n P=0.033）显著降低，差异有统计学意义。<35岁人群中B组（调整后n OR=0.46，95% n CI=0.30~0.71，n P0.05）。曲线拟合分析显示AMH与早期妊娠丢失呈曲线关系，随着AMH水平增加，早期妊娠丢失率逐渐下降后趋于平稳。n 结论:对于首次行胚胎移植术后hCG阳性的女性，AMH水平对于<35岁人群的早期妊娠丢失结局有一定的影响。“,”Objective:To explore the effect of anti-Müllerian hormone (AMH) on early pregnancy loss after first embryo transfer duringn in vitro fertilization (IVF) treatment.n Methods:A total of 3973 women with positive human chorionic gonadotropin (hCG) after first embryo transfer from July 2016 to June 2019 in Reproductive Medical Center, Henan Provincial People\'s Hospital were studied retrospectively. All patients were categorized into four groups according to AMH levels: group A (AMH≤1.97 μg/L), group B (1.97 μg/L5.41 μg/L). Univariate analysis, multivariate logistic regression analysis and curve fitting analysis were used to investigate the effect of AMH level on early pregnancy loss rate.Results:1) The total early pregnancy loss rate of the first transfer cycle was 15.71% (624/3973).There were significant differences in AMH level [(1.21±0.50) μg/L, (2.63±0.38) μg/L, (4.26±0.60) μg/L, (8.26±2.78) μg/L, n P<0.001], age [(32.35±5.00) years, (30.77±4.24) years, (29.90±3.96) years, (29.35±3.85) years,n P<0.001], antral follicular count of both ovaries (8.01±4.04, 11.46±4.40, 13.55±4.73, 16.08±5.08,n P<0.001), number of transfer embryos (1.74±0.44, 1.73±0.45, 1.69±0.46, 1.66±0.47,n P<0.001), developmental days of transfer embryos (cleavage embryos/blastocysts) (85.49%/14.51%, 76.42%/23.58%, 69.55%/30.45%, 65.79%/34.21%,n P<0.001), type of transfer cycles (fresh transfer/frozen transfer) (75.08%/24.92%, 71.15%/28.85%, 57.79%/42.21%, 39.46%/60.54%,n P<0.001) and early pregnancy loss rate (22.12%, 12.25%, 12.76%, 15.64%,n P0.05). 2) After adjusting for confounding factors, group A was set as control group in multivariate logistic regression analysis, the early pregnancy loss rate was significantly lower in group B (adjustedn OR=0.60, 95% n CI=0.46-0.79, n P<0.001) and group C (adjustedn OR=0.70, 95% n CI=0.51-0.97, n P=0.033) for the total women. Further multivariate logistic regression analysis according to age sub-groups showed that the early pregnancy loss rates of group B (adjusted n OR=0.46, 95% n CI=0.30-0.71, n P0.05). The curve fitting analysis found that the relationship between AMH and early pregnancy loss was a curve line. The early pregnancy loss rate was decreased with the increasing of AMH level and gradually plateaued.n Conclusion:For the first embryo transfer cycles, AMH level has some effects on the early pregnancy loss for women no more than 35 years old.