Prediction of reproductive outcomes according to different serum anti-Müllerian hormone levels in females undergoing intracystoplasmic sperm injection.
OBJECTIVE
Serum anti-Müllerian hormone (AMH) is a reliable marker of ovarian reserve, and it has been shown to be correlated with reproductive outcomes in grouped analyses. However, practical data is scarce for the physician and the patients to predict these outcomes in an individual couple according to serum AMH measured prior to assisted reproduction technology (ART) procedures.


METHODS
To address this question, we performed an analytic observational study including 145 females undergoing intracytoplasmic sperm injection (ICSI) in a single center. Results were analyzed according to serum AMH; subgroup analyses were performed by grouping patients according to patient's age and FSH levels.


RESULTS
The risk of cycle cancellation decreased from 64% in patients with serum AMH ≤ 3 pmol/L (0.42 ng/mL) to 21% with AMH ≥ 15 pmol/L (2.10 ng/mL). Cycle cancellation occurred in approximately two-thirds of the patients with AMH ≤ 3 pmol/L irrespective of the FSH level. However, with higher AMH values the risk of cycle cancellation decreased more significantly in patients with normal FSH. The rate of good response increased from almost null in patients with AMH ≤ 3 pmol/L to 61% in those with AMH ≥ 15 pmol/L. The positive correlation between good response and AMH was also significant, but with lower absolute rates, when patients were grouped according to their age or FSH levels. Pregnancy rate increased moderately, but significantly, from 31% with AMH ≤ 3 pmol/L to 35% with AMH ≥ 15 pmol/L.


CONCLUSIONS
We provide estimates of reproductive outcomes according to individualized values of serum AMH, in general and in subgroups according to patient's age or serum FSH, which are helpful for the clinician and the couple in their decision making about starting an assisted reproductive treatment.
Centro Médico, Seremas, Buenos Aires, Argentina.
Santiago
S
Brugo Olmedo
Sabrina
S
De Vincentiis
Evelyn
E
De Martino
Patricia
P
Bedecarrás
Ana María
AM
Blanco
Analía
A
Freire
Mariano G
MG
Buffone
Rodolfo A
RA
Rey
D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D008297:Male; D008597:Menstrual Cycle; D054315:Oocyte Retrieval; D010062:Ovulation Induction; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D011379:Prognosis; D012098:Reproduction / Q000502:physiology*; D020554:Sperm Injections, Intracytoplasmic
D004958:Estradiol; D054304:Anti-Mullerian Hormone; D005640:Follicle Stimulating Hormone