title: Role of baseline antral follicle count and anti-Mullerian hormone in prediction of cumulative live birth in the first in vitro fertilisation cycle: a retrospective cohort analysis.
abstract: OBJECTIVE
  This retrospective study determined for the first time the role of baseline antral follicle count (AFC) and serum anti-Mullerian hormone (AMH) level in the first in-vitro fertilisation (IVF) cycle in predicting cumulative live birth from one stimulation cycle.
  
  
  METHODS
  We studied 1,156 women (median age 35 years) undergoing the first IVF cycle. Baseline AFC and AMH level on the day before ovarian stimulation were analysed. The main outcome measure was cumulative live birth in the fresh plus all the frozen embryo transfers after the same stimulation cycle.
  
  
  RESULTS
  Serum AMH was significantly correlated with AFC. Both AMH and AFC showed significant correlation with age and ovarian response in the stimulated cycle and total number of transferrable embryos. Baseline AFC and serum AMH were significantly higher in subjects attaining a live birth than those who did not in the fresh stimulated cycle, as well as those attaining cumulative live birth. There was a significant trend of higher cumulative live birth rate in women with higher AMH or AFC. However, logistic regression revealed that both AMH and AFC were not significant predictors of cumulative live birth after adjusting for age and number of embryos available for transfer. Considering only one single predictor, the areas under the ROC curves for AMH (0.646, 95% CI 0.616-0.675) and age (0.648, 95% CI 0.618-0.677) were slightly higher than that for AFC (0.617, 95% CI 0.587-0.647) in predicting cumulative live birth. However, a model combining AMH (with or without AFC) and age of the women only classified an addition of less than 2% of subjects correctly compared to the model with age alone.
  
  
  CONCLUSIONS
  Baseline AFC and serum AMH have only modest predictive performance on the occurrence of cumulative live birth, and may not give additional value on top of the women's age.
authors: Department of Obstetrics and Gynaecology, Centre of Assisted Reproduction and Embryology, The University of Hong Kong, Queen Mary Hospital, Hong Kong.
authors: Hang Wun Raymond
authors: HW
authors: Li
authors: Vivian Chi Yan
authors: VC
authors: Lee
authors: Estella Yee Lan
authors: EY
authors: Lau
authors: William Shu Biu
authors: WS
authors: Yeung
authors: Pak Chung
authors: PC
authors: Ho
authors: Ernest Hung Yu
authors: EH
authors: Ng
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D050498:Live Birth; D006080:Ovarian Follicle / Q000166:cytology*; D011247:Pregnancy; D012189:Retrospective Studies
chemical_list: D054304:Anti-Mullerian Hormone
references: J Assist Reprod Genet. 2010 Aug;27(8):449-56
references: 20467803
references: Hum Reprod. 2003 Feb;18(2):328-32
references: 12571169
references: Curr Opin Obstet Gynecol. 2010 Jun;22(3):193-201
references: 20407372
references: Hum Reprod. 2011 Sep;26(9):2532-40
references: 21771773
references: J Clin Endocrinol Metab. 1996 Feb;81(2):571-6
references: 8636269
references: Fertil Steril. 2006 Sep;86(3):588-96
references: 16814289
references: Hum Reprod. 2011 Jul;26(7):1768-74
references: 21558332
references: Gynecol Endocrinol. 2009 Jan;25(1):2-7
references: 19165656
references: Hum Reprod. 2011 Jun;26(6):1537-50
references: 21467203
references: Hum Reprod. 2004 Dec;19(12):2738-41
references: 15459174
references: Hum Reprod. 2010 Oct;25(10):2597-604
references: 20729237
references: Hum Reprod. 2007 Sep;22(9):2414-21
references: 17636277
references: Hum Reprod Update. 2011 Jan-Feb;17(1):46-54
references: 20667894
references: Reprod Biomed Online. 2008 May;16(5):664-70
references: 18492370
references: Ann N Y Acad Sci. 2008 Apr;1127:49-58
references: 18443329
references: Hong Kong Med J. 2009 Dec;15(6):420-6
references: 19966345
references: Hum Reprod. 2012 Mar;27(3):631-6
references: 22238112
references: Hum Reprod Update. 2006 Nov-Dec;12(6):685-718
references: 16891297
references: J Assist Reprod Genet. 2010 Jul;27(7):409-14
references: 20490648
references: Fertil Steril. 2011 Jan;95(1):170-5
references: 20522327
references: Maturitas. 2012 Jan;71(1):28-33
references: 22119275
references: Fertil Steril. 2009 Mar;91(3):705-14
references: 18321493
references: Hum Reprod. 2010 Jan;25(1):221-7
references: 19840990