title: Antimüllerian hormone: prediction of cumulative live birth in gonadotropin-releasing hormone antagonist treatment for in vitro fertilization.
abstract: OBJECTIVE
  To assess the accuracy of antimüllerian hormone (AMH) in predicting cumulative live birth rate (CLBR) within 1 year after treatment initiation in GnRH antagonist treatment cycles for in vitro fertilization (IVF).
  
  
  METHODS
  Observational (retrospective) substudy as part of an ongoing prospective cohort study.
  
  
  METHODS
  University medical center.
  
  
  METHODS
  A total of 487 patients scheduled for IVF/intracytoplasmic sperm injection (ICSI).
  
  
  METHODS
  Patients starting their first IVF/ICSI cycle with 150 or 225 IU recombinant FSH and GnRH antagonist cotreatment were included. Serum samples collected before the first IVF treatment were used to determine AMH. Treatment data after treatment initiation for a maximum of 1 year were recorded.
  
  
  METHODS
  Prediction of CLBR with the use of AMH.
  
  
  RESULTS
  The model for predicting CLBR within 1 year included age at first treatment, AMH, type of infertility, and previous assisted reproductive technology treatment leading to live birth. The accuracy in discriminating between women who did or did not achieve a live birth was only 59%. AMH had intermediate added value in the prediction of CLBR as demonstrated by the net reclassification improvement (total 29.8). A nomogram based on age and AMH was developed by which a subgroup of patients could be identified with the poorest pregnancy prospects.
  
  
  CONCLUSIONS
  The predictive accuracy of AMH for 1-year CLBR in GnRH antagonist treatment cycles was limited and did not yield much additional value on top of age. Withholding treatment based on predictors such as age and AMH, or a combination, remains problematic.
  
  
  BACKGROUND
  www.clinicaltrials.gov, NCT02309073.
authors.affiliation: Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Utrecht, the Netherlands. Electronic address: o.hamdine@umcutrecht.nl.
authors.forename: Ouijdane
authors.initials: O
authors.lastname: Hamdine
authors.affiliation: Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Utrecht, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: Marinus J C
authors.initials: MJC
authors.lastname: Eijkemans
authors.affiliation: Department of Clinical Chemistry and Hematology, University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: Eef G W
authors.initials: EGW
authors.lastname: Lentjes
authors.affiliation: Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: Helen L
authors.initials: HL
authors.lastname: Torrance
authors.affiliation: Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Utrecht, the Netherlands; Academic Unit of Human Development and Health, Princess Anne Hospital, University of Southampton, Southampton, United Kingdom.
authors.forename: Nick S
authors.initials: NS
authors.lastname: Macklon
authors.affiliation: Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: Bart C J M
authors.initials: BCJM
authors.lastname: Fauser
authors.affiliation: Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Broekmans
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D005260:Female; D005307:Fertilization in Vitro; D007987:Gonadotropin-Releasing Hormone / Q000037:antagonists & inhibitors*; D006727:Hormone Antagonists / Q000627:therapeutic use*; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000175:diagnosis* / Q000628:therapy*; D050498:Live Birth / Q000453:epidemiology; D008297:Male; D010062:Ovulation Induction / Q000379:methods; D011247:Pregnancy; D018873:Pregnancy Rate; D011379:Prognosis; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic; D016896:Treatment Outcome
chemical_list: D006727:Hormone Antagonists; D007987:Gonadotropin-Releasing Hormone; D054304:Anti-Mullerian Hormone
keywords: AMH; GnRH antagonist; IVF; live birth