title: Pregnancy prognosis in women with anti-Müllerian hormone below the tenth percentile.
abstract: Although serum anti-Müllerian hormone (AMH) is considered a good predictor of ovarian response during in vitro fertilisation (IVF), pregnancies have been reported with low values, questioning its usefulness as a predictor of treatment outcome. A retrospective study was therefore carried out to assess the IVF treatment outcomes in women with AMH below the tenth percentile of the study population. In all, 134 women with AMH ≤ 3 pmol/L underwent 180 IVF cycles. The mean age at the time of treatment was 37 ± 5 years. Fifty-three (29.4%) cycles were abandoned because of poor response to gonadotrophins, 12 (6.7%) due to absence of eggs at oocyte retrieval and 18 (10%) due to fertilisation failure. Seven (3.8%) had a biochemical pregnancy, 4 (2.2%) had a missed miscarriage and 8 (4.4%) had a live birth. When stratified by age, women older than 42 years had less number of follicles (p < 0.05) and those older than 39 years had less oocytes (p < 0.01) compared to those 35 years and younger. Live births declined with increasing age, when age was assessed as a continuous variable (p = 0.023). Women with low AMH levels have a high probability of treatment cancellation, failure to proceed to embryo transfer and a low chance of achieving a viable pregnancy.
authors.affiliation: Homerton Fertility Centre, Homerton University Hospital, London, UK. abykkoshy@rediffmail.com
authors.forename: Aby Kottal
authors.initials: AK
authors.lastname: Koshy
authors.forename: Anil
authors.initials: A
authors.lastname: Gudi
authors.forename: Amit
authors.initials: A
authors.lastname: Shah
authors.forename: Priya
authors.initials: P
authors.lastname: Bhide
authors.forename: Peter
authors.initials: P
authors.lastname: Timms
authors.forename: Roy
authors.initials: R
authors.lastname: Homburg
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007247:Infertility, Female / Q000097:blood* / Q000628:therapy*; D008875:Middle Aged; D054315:Oocyte Retrieval; D009865:Oocytes / Q000166:cytology; D010062:Ovulation Induction; D011247:Pregnancy; D011256:Pregnancy Outcome; D011379:Prognosis; D012016:Reference Values; D012189:Retrospective Studies; D028761:Withholding Treatment; D055815:Young Adult
chemical_list: D054304:Anti-Mullerian Hormone