title: Anti-Müllerian hormone concentrations in the follicular fluid of the preovulatory follicle are predictive of the implantation potential of the ensuing embryo obtained by in vitro fertilization.
abstract: BACKGROUND
  The strong relationship between serum anti-Müllerian hormone (AMH) levels and the number of antral follicles supports the use of AMH measurements as a quantitative marker of the ovarian follicular status. Yet, it still is unclear whether the aptitude of an individual follicle to produce AMH reflects its reproductive competence.
  
  
  OBJECTIVE
  This study examined the possible relationship between serum or follicular fluid (FF) AMH concentrations and the fate of the ensuing oocytes and embryos obtained by in vitro fertilization-embryo transfer conducted in monodominant follicle cycles.
  
  
  METHODS
  We conducted a prospective study at the University of Paris XI, Assistance Publique-Hôpitaux de Paris, Institut National de la Santé et de la Recherche Médicale U782.
  
  
  METHODS
  Patients included 118 infertile in vitro fertilization-embryo transfer candidates.
  
  
  METHODS
  Concentrations of AMH, progesterone, and estradiol were measured in the serum on cycle d 3 and on the day of oocyte pickup (dOPU), and in FF. Cycles were sorted into three sets of three distinct groups according to whether serum d 3, serum dOPU, and FF AMH concentrations were 30th centile or below (low AMH), between the 31st and the 70th centiles (average AMH), or above the 70th centile (high AMH) of measurements.
  
  
  METHODS
  Clinical pregnancy and embryo implantation rates were assessed.
  
  
  RESULTS
  Clinical pregnancy rates (5.7, 20.0, and 39.5%, respectively; P < 0.002) and embryo implantation rates (11.8, 30.8, and 65.4, respectively; P <0.001) were markedly different among the low, moderate, and high FF AMH groups but not among the serum (d 3 or dOPU) AMH groups. Fertilization rates and embryo morphology remained similar irrespective of AMH concentrations in the serum or in FF. Incidentally, FF AMH concentrations were negatively correlated with FF progesterone (r = -0.27; P <0.003) and FF estradiol (r = -0.21; P <0.02) concentrations.
  
  
  CONCLUSIONS
  Concentrations of AMH in the FF, but not in the serum, constitute a useful follicular marker of embryo implantation and are negatively related to FF progesterone and estradiol concentrations.
authors.affiliation: Department of Obstetrics and Gynecology and Reproductive Medicine, Hôpital Antoine Béclère, 157 rue de la Porte de Trivaux, 92141 Clamart, France. renato.fanchin@abc.ap-hop-paris.fr
authors.forename: Renato
authors.initials: R
authors.lastname: Fanchin
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Mendez Lozano
authors.forename: Nelly
authors.initials: N
authors.lastname: Frydman
authors.forename: Alain
authors.initials: A
authors.lastname: Gougeon
authors.forename: Nathalie
authors.initials: N
authors.lastname: di Clemente
authors.forename: René
authors.initials: R
authors.lastname: Frydman
authors.forename: Joëlle
authors.initials: J
authors.lastname: Taieb
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone; D010064:Embryo Implantation / Q000502:physiology*; D004622:Embryo, Mammalian / Q000378:metabolism*; D004958:Estradiol / Q000097:blood / Q000378:metabolism; D005260:Female; D005307:Fertilization in Vitro; D015571:Follicular Fluid / Q000737:chemistry / Q000378:metabolism*; D005498:Follicular Phase / Q000378:metabolism*; D006023:Glycoproteins / Q000032:analysis / Q000097:blood / Q000378:metabolism*; D006801:Humans; D016015:Logistic Models; D006080:Ovarian Follicle / Q000000981:diagnostic imaging / Q000378:metabolism*; D011237:Predictive Value of Tests; D011247:Pregnancy; D018873:Pregnancy Rate; D011374:Progesterone / Q000097:blood / Q000378:metabolism; D013735:Testicular Hormones / Q000032:analysis / Q000097:blood / Q000378:metabolism*; D014463:Ultrasonography
chemical_list: D006023:Glycoproteins; D013735:Testicular Hormones; D011374:Progesterone; D004958:Estradiol; D054304:Anti-Mullerian Hormone