title: Different ovarian response by age in an anti-Müllerian hormone-matched group undergoing in vitro fertilization.
abstract: BACKGROUND
  Recently, serum anti-Müllerian hormone (AMH) has been used as a good marker of ovarian response during in vitro fertilization (IVF). However, in the clinical setting, we felt that ovarian response was clearly different by age with the same AMH level. Then in this study we evaluated the relationship between serum AMH, age and parameters related to ovarian response and compared these parameters in regard to age within serum AMH-matched group.
  
  
  RESULTS
  The relationship of these parameters were evaluated retrospectively in patients undergoing their first IVF cycle under a GnRH agonist flare up protocol (n = 456) between October 2008 and October 2010 in our clinic. To understand the relations between variables described above, principal component analysis (PCA) was performed. PCA revealed patients' age was at the different dimension from serum AMH and other variables. Therefore at first we segregated all patients into Low, Normal and High responder groups by their serum AMH using cut-off value of receiver operator characteristics curve analysis. Secondary, we divided each responder group into four subgroups according to patients' age. The high aged subgroups required a significantly higher dose of gonadotropin and a longer duration of stimulation; however, they had significantly lower peak E2 and a smaller number of total oocytes as well as M2 oocytes compared to the low aged subgroups.
  
  
  CONCLUSIONS
  The influence of aging on the ovarian response was clearly seen in all groups; the ovarian response tended to decrease as patients' age increased with the same AMH level. Therefore serum AMH in combination with age is a better indicator than AMH alone.
authors.affiliation: Asada Ladies' Clinic, Matsushincho, Kasugai, Aichi, Japan. hihonma@sapmed.ac.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Honnma
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Baba
authors.forename: Masahiro
authors.initials: M
authors.lastname: Sasaki
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Hashiba
authors.forename: Hisanori
authors.initials: H
authors.lastname: Oguri
authors.forename: Takanori
authors.initials: T
authors.lastname: Fukunaga
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Endo
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Asada
mesh_terms: D000328:Adult; D000367:Age Factors; D054304:Anti-Mullerian Hormone / Q000097:blood*; D006063:Chorionic Gonadotropin / Q000008:administration & dosage; D005260:Female; D005298:Fertility / Q000502:physiology; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000097:blood; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists / Q000037:antagonists & inhibitors; D006062:Gonadotropins / Q000008:administration & dosage; D006801:Humans; D009865:Oocytes / Q000502:physiology; D010062:Ovulation Induction; D011247:Pregnancy; D011256:Pregnancy Outcome
chemical_list: D006063:Chorionic Gonadotropin; D006062:Gonadotropins; D007987:Gonadotropin-Releasing Hormone; D054304:Anti-Mullerian Hormone; D005640:Follicle Stimulating Hormone
references.citation: Fertil Steril. 2009 Jun;91(6):2616-9
references.pmid: 18555223
references.citation: Hum Reprod. 2008 Jan;23(1):160-7
references.pmid: 18000172
references.citation: Hum Reprod Update. 2010 Mar-Apr;16(2):113-30
references.pmid: 19793843
references.citation: Fertil Steril. 2011 May;95(6):1990-5
references.pmid: 21419407
references.citation: Hum Reprod. 2009 Apr;24(4):867-75
references.pmid: 19136673
references.citation: Fertil Steril. 2008 Aug;90(2):395-400
references.pmid: 17919608
references.citation: Hum Reprod Update. 2006 Nov-Dec;12(6):685-718
references.pmid: 16891297
references.citation: Endocrinology. 2007 May;148(5):2301-8
references.pmid: 17255205
references.citation: Hum Reprod. 2002 Jun;17(6):1519-24
references.pmid: 12042271
references.citation: Reprod Biomed Online. 2006 Nov;13(5):639-44
references.pmid: 17169172
references.citation: Fertil Steril. 2011 Feb;95(2):747-50
references.pmid: 21074758
references.citation: Hum Reprod. 2008 Jun;23(6):1359-65
references.pmid: 18387961
references.citation: Fertil Steril. 1993 Jan;59(1):1-5
references.pmid: 8419194
references.citation: Fertil Steril. 2005 Feb;83(2):291-301
references.pmid: 15705365
references.citation: Obstet Gynecol Clin North Am. 1993 Jun;20(2):261-72
references.pmid: 8367130
references.citation: Fertil Steril. 2006 Mar;85(3):592-6
references.pmid: 16500324
references.citation: Hum Reprod. 2009 May;24(5):1085-91
references.pmid: 19176542
references.citation: Br J Obstet Gynaecol. 1994 Nov;101(11):999-1002
references.pmid: 7999732
references.citation: Fertil Steril. 2011 Feb;95(2):832-4
references.pmid: 20970126
references.citation: Eur J Obstet Gynecol Reprod Biol. 2011 Aug;157(2):239-40
references.pmid: 21477915
references.citation: J Natl Cancer Inst Monogr. 2005;(34):18-21
references.pmid: 15784815
references.citation: Hum Reprod Update. 2003 Jan-Feb;9(1):61-76
references.pmid: 12638782
references.citation: Acta Paediatr. 2007 May;96(5):644-7
references.pmid: 17376185
references.citation: Fertil Steril. 2008 Sep;90(3):737-43
references.pmid: 17923131
references.citation: Hum Reprod. 2006 Dec;21(12):3103-7
references.pmid: 16923748
references.citation: Hum Reprod. 1995 Dec;10 Suppl 2:77-83
references.pmid: 8745304
references.citation: Hum Reprod. 2000 Sep;15(9):1937-42
references.pmid: 10966990
references.citation: BJOG. 2004 Nov;111(11):1248-53
references.pmid: 15521870
references.citation: J Clin Endocrinol Metab. 1996 Feb;81(2):571-6
references.pmid: 8636269
references.citation: Reprod Biomed Online. 2007 Apr;14(4):450-4
references.pmid: 17425826
references.citation: Br J Obstet Gynaecol. 1998 Jan;105(1):107-12
references.pmid: 9442172