title: Live birth chances in women with extremely low-serum anti-Mullerian hormone levels.
abstract: BACKGROUND
  To determine whether women with extremely low-serum anti-Mullerian hormone (AMH) levels (<0.1-0.4 ng/ml) still demonstrate live birth potential with assisted reproduction and whether such potential is age dependent.
  
  
  METHODS
  Between January 2006 and October 2009, 128 consecutive infertility patients with AMH ≤0.4 ng/ml were retrospectively evaluated for pregnancy chances and live birth rates after IVF.
  
  
  RESULTS
  Patients presented at a mean (±SD) age of 40.8 ± 4.1 years, with mean (±SD) baseline FSH of 15.7 ± 11.1 mIU/ml and mean (±SD) AMH of 0.2 ± 0.1 ng/ml. One hundred and twenty-eight women underwent a total of 254 IVF cycles. Twenty clinical pregnancies were recorded (7.9% per cycle start [95% confidence interval (CI): 4.9-11.9%]; 15.6% cumulative [CI: 9.8-23.1%]). These pregnancies resulted in 13 live births in 12 women (i.e. 11 singletons and a pair of twins) and 8 patients miscarried. Eight deliveries occurred after the first cycle (6.3% per cycle start) and four after subsequent IVF cycles (3.2%). When evaluated according to female age, 70 women ≤42 years presented with 16 clinical pregnancies that resulted in 10 deliveries (14.3%), while 58 patients >42 years presented with four clinical pregnancies that resulted in 2 deliveries (3.4%), representing a reduced pregnancy chance (P = 0.013) and delivery rate (P = 0.036) versus age ≤42 years.
  
  
  CONCLUSIONS
  With extremely low-serum AMH levels, moderate, but reasonable pregnancy and live birth rates are still possible. Extremely low AMH levels do not seem to represent an appropriate marker for withholding fertility treatment.
authors.affiliation: Department of Obstetrics and Gynecology, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria. andrea.weghofer@meduniwien.ac.at
authors.forename: Andrea
authors.initials: A
authors.lastname: Weghofer
authors.forename: Wolf
authors.initials: W
authors.lastname: Dietrich
authors.forename: David H
authors.initials: DH
authors.lastname: Barad
authors.forename: Norbert
authors.initials: N
authors.lastname: Gleicher
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001723:Birth Rate; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000494:pharmacology; D006801:Humans; D007247:Infertility, Female / Q000628:therapy*; D050498:Live Birth; D008875:Middle Aged; D011247:Pregnancy; D018873:Pregnancy Rate
chemical_list: D015415:Biomarkers; D054304:Anti-Mullerian Hormone; D005640:Follicle Stimulating Hormone