title: Ovarian response and cumulative live birth rate of women undergoing in-vitro fertilisation who had discordant anti-Mullerian hormone and antral follicle count measurements: a retrospective study.
abstract: OBJECTIVE
  To evaluate ovarian response and cumulative live birth rate of women undergoing in-vitro fertilization (IVF) treatment who had discordant baseline serum anti-Mullerian hormone (AMH) level and antral follicle count (AFC).
  
  
  METHODS
  This is a retrospective cohort study on 1,046 women undergoing the first IVF cycle in Queen Mary Hospital, Hong Kong. Subjects receiving standard IVF treatment with the GnRH agonist long protocol were classified according to their quartiles of baseline AMH and AFC measurements after GnRH agonist down-regulation and before commencing ovarian stimulation. The number of retrieved oocytes, ovarian sensitivity index (OSI) and cumulative live-birth rate for each classification category were compared.
  
  
  RESULTS
  Among our studied subjects, 32.2% were discordant in their AMH and AFC quartiles. Among them, those having higher AMH within the same AFC quartile had higher number of retrieved oocytes and cumulative live-birth rate. Subjects discordant in AMH and AFC had intermediate OSI which differed significantly compared to those concordant in AMH and AFC on either end. OSI of those discordant in AMH and AFC did not differ significantly whether either AMH or AFC quartile was higher than the other.
  
  
  CONCLUSIONS
  When AMH and AFC are discordant, the ovarian responsiveness is intermediate between that when both are concordant on either end. Women having higher AMH within the same AFC quartile had higher number of retrieved oocytes and cumulative live-birth rate.
authors.affiliation: Centre of Assisted Reproduction and Embryology, Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong.
authors.forename: Hang Wun Raymond
authors.initials: HW
authors.lastname: Li
authors.affiliation: Centre of Assisted Reproduction and Embryology, Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong.
authors.forename: Vivian Chi Yan
authors.initials: VC
authors.lastname: Lee
authors.affiliation: Centre of Assisted Reproduction and Embryology, Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong.
authors.forename: Estella Yee Lan
authors.initials: EY
authors.lastname: Lau
authors.affiliation: Centre of Assisted Reproduction and Embryology, Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong.
authors.forename: William Shu Biu
authors.initials: WS
authors.lastname: Yeung
authors.affiliation: Centre of Assisted Reproduction and Embryology, Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong.
authors.forename: Pak Chung
authors.initials: PC
authors.lastname: Ho
authors.affiliation: Centre of Assisted Reproduction and Embryology, Department of Obstetrics and Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong.
authors.forename: Ernest Hung Yu
authors.initials: EH
authors.lastname: Ng
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D001723:Birth Rate; D003710:Demography; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists / Q000627:therapeutic use; D006801:Humans; D007247:Infertility, Female / Q000628:therapy; D006080:Ovarian Follicle / Q000166:cytology*; D010062:Ovulation Induction; D011247:Pregnancy; D012189:Retrospective Studies
chemical_list: D007987:Gonadotropin-Releasing Hormone; D054304:Anti-Mullerian Hormone