title: The value of anti-Mullerian hormone measurement in the long GnRH agonist protocol: association with ovarian response and gonadotrophin-dose adjustments.
abstract: BACKGROUND
  This study evaluated the predictive value of serum and follicular fluid (FF) concentrations of anti-Müllerian hormone (AMH) with respect to treatment outcome variables in an IVF cycle.
  
  
  METHODS
  A retrospective analysis was performed with data from 731 normogonadotrophic women undergoing controlled ovarian stimulation after stimulation with highly purified menotrophin (HP-hMG) or rFSH following a long GnRH agonist protocol.
  
  
  RESULTS
  In both treatment groups, the serum AMH concentration at the start of the stimulation was significantly (P < 0.001) positively correlated with the serum levels of estradiol (HP-hMG: r = 0.45; rFSH: r = 0.55), androstenedione (HP-hMG: r = 0.50; rFSH: 0.49) and total testosterone (HP-hMG: r = 0.40; rFSH: r = 0.36) at the end of the stimulation as well as the number of oocytes retrieved (HP-hMG: r = 0.48; rFSH: r = 0.62), the AMH concentration in FF (HP-hMG: r = 0.55; rFSH: 0.61) and the serum progesterone concentration (HP-hMG: r = 0.39; rFSH: r = 0.50) at oocyte retrieval. For both treatments, serum AMH at the start of the stimulation was a good predictor of the need to increase or decrease the gonadotrophin dose on stimulation day 6 and of ovarian response below (<7 oocytes) or above (>15 oocytes) the target. No significant relationships were observed between serum AMH and embryo quality or ongoing pregnancy.
  
  
  CONCLUSIONS
  The serum AMH concentration at the start of the stimulation in IVF patients down-regulated with GnRH agonist in the long protocol revealed a positive relationship with ovarian response to gonadotrophins in terms of oocytes retrieved and accompanying endocrine response. AMH is a good predictor of the need for gonadotrophin-dose adjustment on stimulation day 6 for patients with a fixed starting dose, but a poor predictor of embryo quality and pregnancy chances in individual patients.
authors.affiliation: UZ Brussel, Laboratory of Clinical Chemistry and Radio-immunology, Vrije Universiteit Brussel, Brussel, Belgium.
authors.forename: Ellen
authors.initials: E
authors.lastname: Anckaert
authors.forename: Johan
authors.initials: J
authors.lastname: Smitz
authors.forename: Johan
authors.initials: J
authors.lastname: Schiettecatte
authors.forename: Bjarke M
authors.initials: BM
authors.lastname: Klein
authors.forename: Joan-Carles
authors.initials: JC
authors.lastname: Arce
mesh_terms: D000328:Adult; D000735:Androstenedione / Q000097:blood; D054304:Anti-Mullerian Hormone / Q000032:analysis* / Q000097:blood; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D015571:Follicular Fluid / Q000737:chemistry; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D010062:Ovulation Induction; D011247:Pregnancy; D011256:Pregnancy Outcome; D011374:Progesterone / Q000097:blood; D012189:Retrospective Studies; D013739:Testosterone / Q000097:blood
chemical_list: D007987:Gonadotropin-Releasing Hormone; D013739:Testosterone; D000735:Androstenedione; D011374:Progesterone; D004958:Estradiol; D054304:Anti-Mullerian Hormone