title: Antimüllerian hormone in gonadotropin releasing-hormone antagonist cycles: prediction of ovarian response and cumulative treatment outcome in good-prognosis patients.
abstract: OBJECTIVE
  To assess the relationships between serum antimüllerian hormone (AMH) and ovarian response and treatment outcomes in good-prognosis patients undergoing controlled ovarian stimulation using a gonadotropin-releasing hormone (GnRH) antagonist protocol.
  
  
  METHODS
  Secondary analysis of data prospectively collected in a randomized, assessor-blind trial comparing two different gonadotropin preparations with respect to ongoing pregnancy rate.
  
  
  METHODS
  Twenty-five centers in seven countries.
  
  
  METHODS
  749 women, aged 21 to 34 years, with primary diagnosis of infertility being unexplained infertility or mild male factor infertility and with serum follicle-stimulating hormone (FSH) level 1-12 IU/L and antral follicle count (AFC) ≥10.
  
  
  METHODS
  Controlled ovarian stimulation with highly purified human menopausal gonadotropin (hphMG) or recombinant FSH in a GnRH antagonist cycle with compulsory single-blastocyst transfer and potential subsequent 1-year cryopreserved blastocyst replacement in natural cycles.
  
  
  METHODS
  Relationships between AMH at start of stimulation and ovarian response and treatment outcome.
  
  
  RESULTS
  Serum AMH concentration was strongly correlated with oocyte yield: AMH accounted for 85%, FSH for 14%, and inhibin B and AFC for <1% each of the explained variation in oocyte yield. Also, AMH showed a high accuracy for the prediction of poor (≤3 oocytes) and high response (≥15 oocytes), which was statistically significantly better than basal FSH, AFC, or inhibin B. AMH was statistically significantly positively associated with ongoing pregnancy rate in the fresh cycle as well as with the 1-year cumulative ongoing pregnancy and live-birth rates.
  
  
  CONCLUSIONS
  There is a positive relationship between AMH and oocyte yield in GnRH antagonist cycles, and AMH is the best predictor for identifying patients with poor and high ovarian response. The positive association between AMH and cumulative live-birth rates after fresh and cryopreserved cycles reflects the availability of more oocytes/blastocysts, not higher quality.
  
  
  BACKGROUND
  NCT00884221.
authors: Reproductive Health, Ferring Pharmaceuticals A/S, Copenhagen, Denmark. jca@ferring.com
authors: Joan-Carles
authors: JC
authors: Arce
authors: Antonio
authors: A
authors: La Marca
authors: Bjarke
authors: B
authors: Mirner Klein
authors: Anders
authors: A
authors: Nyboe Andersen
authors: Richard
authors: R
authors: Fleming
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000037:antagonists & inhibitors* / Q000378:metabolism; D006801:Humans; D007247:Infertility, Female / Q000097:blood* / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D054315:Oocyte Retrieval / Q000379:methods / Q000639:trends; D010053:Ovary / Q000378:metabolism*; D010062:Ovulation Induction / Q000379:methods / Q000639:trends; D011237:Predictive Value of Tests; D011247:Pregnancy; D018873:Pregnancy Rate / Q000639:trends; D011379:Prognosis; D011446:Prospective Studies; D016037:Single-Blind Method; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007987:Gonadotropin-Releasing Hormone; D054304:Anti-Mullerian Hormone