Anti-Müllerian hormone: correlation of early follicular, ovulatory and midluteal levels with ovarian response and cycle outcome in intracytoplasmic sperm injection patients.
OBJECTIVE
To measure serum anti-Müllerian hormone (AMH) during different phases of the menstrual cycle and to correlate the measurements with ovarian response and clinical-pregnancy rates in intracytoplasmic sperm injection cycles.


METHODS
Prospective cohort study.


METHODS
University IVF unit.


METHODS
Thirty-three patients undergoing their first intracytoplasmic sperm injection treatment cycle with a long protocol.


METHODS
On day 3 of the menstrual cycle, measurements of AMH, FSH, and LH and ultrasound evaluation of mean ovarian volume and antral follicle count were performed. Anti-Müllerian hormone was remeasured at ovulation and 7-8 days later (midluteal).


METHODS
Poor response and number of oocytes were primary outcomes. Clinical pregnancy was a secondary outcome.


RESULTS
Levels of AMH were lower in poor ovarian responders than in normal responders. Number of oocytes retrieved was statistically significantly correlated with midluteal AMH, day 3 AMH, antral follicle count, ovulatory AMH, mean ovarian volume (r = 0.89, 0.88, 0.88, 0.86, 0.66, respectively) and with day 3 FSH (r = -0.41). Midluteal, day 3, and ovulatory AMH showed a good discriminatory potential for prediction of poor response (area under the receiver operating characteristics curves, 0.977, 0.9, and 0.89, respectively). Midluteal and early AMH were statistically significant predictors of clinical pregnancy.


CONCLUSIONS
A strong association exists between midluteal, early follicular, ovulatory AMH levels and number of oocytes retrieved. Midluteal and early follicular AMH may offer good prognostic value for clinical pregnancy.
Department of Obstetrics and Gynecology, Faculty of Medicine, the University of Zagazig, Zagazig, Egypt.
Eman A
EA
Elgindy
Dahlia O
DO
El-Haieg
Azza
A
El-Sebaey
D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood / Q000627:therapeutic use*; D015331:Cohort Studies; D004624:Embryo Transfer / Q000379:methods; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D005498:Follicular Phase / Q000187:drug effects / Q000502:physiology; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy; D008183:Luteal Phase / Q000187:drug effects / Q000502:physiology; D007986:Luteinizing Hormone / Q000097:blood; D008597:Menstrual Cycle / Q000187:drug effects; D054315:Oocyte Retrieval / Q000379:methods; D006080:Ovarian Follicle / Q000187:drug effects / Q000502:physiology*; D010053:Ovary / Q000033:anatomy & histology / Q000187:drug effects / Q000502:physiology*; D010060:Ovulation / Q000187:drug effects / Q000502:physiology*; D010062:Ovulation Induction / Q000379:methods; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*
D004958:Estradiol; D054304:Anti-Mullerian Hormone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone