title: Serum anti-Müllerian hormone levels as a predictor of the ovarian response and IVF outcomes.
abstract: OBJECTIVE
  The aim of this study was to investigate whether anti-Mullerian hormone (AMH) levels could be predict ovarian poor/hyper response and IVF cycle outcome.
  
  
  METHODS
  Between May 2010 and January 2011, serum AMH levels were evaluated with retrospective analysis. Three hundred seventy infertile women undergoing 461 IVF cycles between the ages of 20 and 42 were studied. We defined the poor response as the number of oocytes retrieved was equal or less than 3, and the hyper response as more than 25 oocytes retrieved. Serum AMH was measured by commercial enzyme-linked immunoassay.
  
  
  RESULTS
  The number of oocytes retrieved was more correlated with the serum AMH level (r=0.781, p<0.01) than serum FSH (r=-0.412, p<0.01). The cut-off value of serum AMH levels for poor response was 1.05 ng/mL (receiver operating characteristic [ROC] curves/area under the curve [AUC], ROC(AUC)=0.85, sensitivity 74%, specificity 87%). Hyper response cut-off value was 3.55 ng/mL (ROC(AUC)=0.91, sensitivity 94%, specificity 81%). When the study group was divided according to the serum AMH levels (low: <1.05 ng/mL, middle: 1.05 ng/mL - 3.55 ng/mL, high: >3.55 ng/mL), the groups showed no statistical differences in mature oocyte rates (71.6% vs. 76.5% vs. 74.8%) or fertilization rates (76.9% vs. 76.6% vs. 73.8%), but showed significant differences in clinical pregnancy rates (21.7% vs. 24.1% vs. 40.8%, p=0.017).
  
  
  CONCLUSIONS
  The serum AMH level can be used to predict the number of oocytes retrieved in patients, distinguishing poor and high responders.
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea.
authors.forename: Min Hye
authors.initials: MH
authors.lastname: Choi
authors.forename: Ji Hee
authors.initials: JH
authors.lastname: Yoo
authors.forename: Hye Ok
authors.initials: HO
authors.lastname: Kim
authors.forename: Sun Hwa
authors.initials: SH
authors.lastname: Cha
authors.forename: Chan Woo
authors.initials: CW
authors.lastname: Park
authors.forename: Kwang Moon
authors.initials: KM
authors.lastname: Yang
authors.forename: In Ok
authors.initials: IO
authors.lastname: Song
authors.forename: Mi Kyoung
authors.initials: MK
authors.lastname: Koong
authors.forename: Inn Soo
authors.initials: IS
authors.lastname: Kang