title: Prognostic indicators of assisted reproduction technology outcomes of cycles with ultralow serum antimüllerian hormone: a multivariate analysis of over 5,000 autologous cycles from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System database for 2012-2013.
abstract: OBJECTIVE
  To assess cycle outcomes when antimüllerian hormone (AMH) is ultralow (≤0.16 ng/mL) and to determine which parameters contribute to the probability of cycle cancellation and/or outcome.
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  5,087 (7.3%) fresh and 243 (1.5%) thawed cycles with ultralow AMH values.
  
  
  METHODS
  Linear and logistic regression, comparison with age-matched cycles with normal AMH concentrations.
  
  
  METHODS
  Cancellation rate; number of retrieved oocytes, embryos, transferred embryos, and cryopreserved embryos; clinical pregnancy, live-birth, and multiple birth rates.
  
  
  RESULTS
  The total cancellation rate per cycle start for fresh cycles was 54%. Of these, 38.6% of the cycles were canceled before retrieval, and 3.3% of cycles obtained no oocytes at time of retrieval. Of all retrieval attempts, 50.7% had three oocytes or fewer retrieved, and 25.1% had no embryo transfer. The live-birth rates were 9.5% per cycle start. Cycles with ultralow AMH levels compared with age-matched normal AMH cycles demonstrated more than a fivefold greater pre-retrieval cancellation rate, a twofold less live-birth rate per cycle and a 4.5-fold less embryo cryopreservation rate.
  
  
  CONCLUSIONS
  Refusing treatment solely on the basis of ultralow AMH levels is not advisable, but patients should be counseled appropriately about the prognostic factors for cancellation and outcomes.
authors.affiliation: Oregon Health and Science University, Portland, Oregon. Electronic address: seiferd@ohsu.edu.
authors.forename: David B
authors.initials: DB
authors.lastname: Seifer
authors.affiliation: Conestoga College, Kitchener, Ontario, Canada.
authors.forename: Oded
authors.initials: O
authors.lastname: Tal
authors.affiliation: Redshift Technologies, New York, New York.
authors.forename: Ethan
authors.initials: E
authors.lastname: Wantman
authors.affiliation: Redshift Technologies, New York, New York.
authors.forename: Preeti
authors.initials: P
authors.lastname: Edul
authors.affiliation: Stanford Medical Center, Stanford, California.
authors.forename: Valerie L
authors.initials: VL
authors.lastname: Baker
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D015925:Cryopreservation; D016208:Databases, Factual; D004624:Embryo Transfer; D005260:Female; D005298:Fertility; D005307:Fertilization in Vitro; D006801:Humans; D007246:Infertility / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D016014:Linear Models; D050498:Live Birth; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D054315:Oocyte Retrieval; D018579:Patient Selection; D011247:Pregnancy; D018873:Pregnancy Rate; D011272:Pregnancy, Multiple; D027724:Reproductive Techniques, Assisted; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015415:Biomarkers; D054304:Anti-Mullerian Hormone
keywords: AMH; ART outcomes; low AMH; multiple births; prognostic factors; ultralow AMH