title: IVF results in patients with very low serum AMH are significantly affected by chronological age.
abstract: OBJECTIVE
  The aims of this study were to assess the outcome of in vitro fertilization (IVF) in women with very low circulating anti-müllerian hormone (AMH) and to investigate factors affecting their probability of pregnancy.
  
  
  METHODS
  The outcome of 448 IVF cycles in 361 women with circulating AMH <0.5 ng/ml was retrospectively analyzed.
  
  
  RESULTS
  Cycle cancellation rate was 14.5 %; patients whose cycle was cancelled had significantly lower AMH than women who reached oocyte pickup (OPU). Among those who reached OPU, age significantly affected the success rate: despite comparable AMH levels, patients below 35 years obtained significantly more oocytes and a better clinical pregnancy rate (CPR)/OPU than patients aged 35-39 or 40-43 (31 % vs. 23.2 % vs. 10.2 %, respectively; p = 0.001). Differently, comparable IVF results were observed stratifying patients for AMH levels in the range 0.14-0.49 ng/ml. Multivariable logistic regression analysis confirmed that the probability of pregnancy was significantly affected by age, but not by small differences in AMH level.
  
  
  CONCLUSIONS
  Women with very low (<0.5 ng/ml) AMH levels undergoing IVF still have reasonable chances of achieving a pregnancy, but their prognosis is significantly affected by chronological age. Very low AMH levels are associated with a relevant risk of cycle cancellation but should not be considered a reason to exclude a couple from IVF.
authors.affiliation: Gynecology and Obstetrics I, Physiopathology of Reproduction and IVF Unit, S. Anna Hospital, Department of Surgical Sciences, University of Torino, Torino, Italy. aerre99@yahoo.com.
authors.forename: Alberto
authors.initials: A
authors.lastname: Revelli
authors.affiliation: Gynecology and Obstetrics I, Physiopathology of Reproduction and IVF Unit, S. Anna Hospital, Department of Surgical Sciences, University of Torino, Torino, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Biasoni
authors.affiliation: Gynecology and Obstetrics I, Physiopathology of Reproduction and IVF Unit, S. Anna Hospital, Department of Surgical Sciences, University of Torino, Torino, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Gennarelli
authors.affiliation: Gynecology and Obstetrics I, Physiopathology of Reproduction and IVF Unit, S. Anna Hospital, Department of Surgical Sciences, University of Torino, Torino, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Canosa
authors.affiliation: Medical Statistics Unit, Department of Public Health and Microbiology, University of Torino, Torino, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Dalmasso
authors.affiliation: Gynecology and Obstetrics I, Physiopathology of Reproduction and IVF Unit, S. Anna Hospital, Department of Surgical Sciences, University of Torino, Torino, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Benedetto
mesh_terms: D000367:Age Factors; D054304:Anti-Mullerian Hormone / Q000097:blood*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D016015:Logistic Models; D015999:Multivariate Analysis; D011247:Pregnancy; D018873:Pregnancy Rate; D016896:Treatment Outcome
chemical_list: D054304:Anti-Mullerian Hormone
keywords: Anti-müllerian hormone (AMH); Controlled ovarian stimulation; IVF outcome; Ovarian reserve