title: Antimüllerian hormone as predictor of implantation and clinical pregnancy after assisted conception: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To assess whether antimüllerian hormone (AMH) is a predictor of implantation and/or clinical pregnancy in women undergoing assisted reproductive technology.
  
  
  METHODS
  Systematic review and meta-analysis.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Women undergoing IVF/intracytoplasmic sperm injection in nondonor cycles.
  
  
  METHODS
  Measurement of serum AMH level.
  
  
  METHODS
  Diagnostic odds ratio (OR) and summary receiver operating characteristic curve (AUC) for AMH as a predictor of implantation and/or clinical pregnancy.
  
  
  RESULTS
  A total of 525 observational studies were identified, of which 19 were selected (comprising 5,373 women). Studies reporting clinical pregnancy rates in women with unspecified ovarian reserve (n = 11), diminished ovarian reserve (DOR) (n = 4), and polycystic ovary syndrome (n = 4) were included, together with studies reporting implantation rates (n = 4). The OR for AMH as a predictor of implantation in women with unspecified ovarian reserve (n = 1,591) was 1.83 (95% confidence interval [CI] 1.49-2.25), whereas the AUC was 0.591 (95% CI 0.563-0.618). The OR for AMH as a predictor of clinical pregnancy in these women (n = 4,324) was 2.10 (95% CI 1.82-2.41), whereas the AUC was 0.634 (95% CI 0.618-0.650). The predictive ability of AMH for pregnancy was greatest in women with DOR (n = 615), with OR and AUC of 3.96 (95% CI 2.57-6.10) and 0.696 (95% CI 0.641-0.751), respectively. In contrast, AMH had no significant predictive ability in women with PCOS (n = 414), with OR and AUC of 1.18 (95% CI 0.53-2.62) and 0.600 (95% CI 0.547-0.653), respectively.
  
  
  CONCLUSIONS
  Antimüllerian hormone has weak association with implantation and clinical pregnancy rates in assisted reproductive technology but may still have some clinical utility in counseling women undergoing fertility treatment regarding pregnancy rates, particularly those with DOR.
authors.affiliation: Division of Reproductive Endocrinology & Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut. Electronic address: reshef.tal@yale.edu.
authors.forename: Reshef
authors.initials: R
authors.lastname: Tal
authors.affiliation: School of Business and Hospitality, Conestoga College, Kitchener, Ontario, Canada.
authors.forename: Oded
authors.initials: O
authors.lastname: Tal
authors.affiliation: Division of Reproductive Endocrinology & Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut.
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Seifer
authors.affiliation: Division of Reproductive Endocrinology & Infertility, Department of Obstetrics and Gynecology, Oregon Health Science University, Portland, Oregon.
authors.forename: David B
authors.initials: DB
authors.lastname: Seifer
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone; D015415:Biomarkers / Q000097:blood; D010064:Embryo Implantation; D005260:Female; D005307:Fertilization in Vitro / Q000706:statistics & numerical data*; D006801:Humans; D007247:Infertility, Female / Q000097:blood* / Q000453:epidemiology / Q000628:therapy*; D008875:Middle Aged; D064887:Observational Studies as Topic; D065851:Ovarian Reserve; D010053:Ovary / Q000378:metabolism / Q000473:pathology*; D010062:Ovulation Induction / Q000706:statistics & numerical data*; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D015995:Prevalence; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D015415:Biomarkers; D054304:Anti-Mullerian Hormone
keywords: Antimullerian hormone (AMH); clinical pregnancy; implantation; meta-analysis; predictor