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How FSH and AMH reflect probabilities of oocyte numbers in poor prognosis patients with small oocyte yields

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Abstract

In poor prognosis patients undergoing in vitro fertilization, advance determinations of likely oocyte yields are especially important since oocyte numbers to large degree determine in vitro fertilization cycle outcomes. Based on baseline follicle stimulating hormone and anti-müllerian hormone levels at time of initial presentation, we here, therefore, determined at all ages the probabilities of obtaining 1–≥5 oocytes in a retrospective analysis of 1554 consecutive patients undergoing in vitro fertilization cycles at an academically affiliated private fertility center. At lowest levels (≤2.5 mIU/mL), Follicle stimulating hormone at all ages was highly predictable for ≥1 oocyte (88–96 %). Probabilities declined and diverged between ages with increasing follicle stimulating hormone, though narrowed again at high follicle stimulating hormone. Anti-Müllerian hormone demonstrated at higher levels (2.5–≥5 ng/ml) at all ages almost perfect probabilities (99–100 %). With declining anti-Müllerian hormone, age categories, however, increasingly diverged, though to lesser degree than follicle stimulating hormone. In poor prognosis patients, follicle stimulating hormone and anti-Müllerian hormone, thus, offer at different ages very specific probabilities for retrieval of 1–≥5 oocytes. Since oocyte numbers are associated with embryo numbers, and numbers of transferable embryos with live birth rates, here presented probability tables should facilitate improved prognostication of poor prognosis patients. Discrepancies in here reported probabilities between follicle stimulating hormone and anti-müllerian hormone also further define follicle stimulating hormone and anti-müllerian hormone in their respective abilities to represent functional ovarian reserve at different ages.

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Author contributions

Study concept: N.G., V.A.K., D.H.B.; Data accumulation: S.K.D., Laboratory: Y-G.W., Q.W., L.Z., D.F.A; Statistics: S.K.D, D.H.B.; Data interpretation: N.G., S.K.D., D.H.B., V.A.K., A.S., D.F.A.; Initial manuscript: N.G.; Significant editorial revisions: N.G., V.A.K., S.K.D., D.H.B.; Overall project supervision: N.G.; All authors approved of the final manuscript.

Funding

This research was supported by intramural funds from The Center for Human Reproduction and grants from The Foundation for Reproductive Medicine, a not-for-profit research foundation.

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Authors and Affiliations

  1. The Center for Human Reproduction, New York, NY, 10021, USA

    Norbert Gleicher, Sarah K. Darmon, Vitaly A. Kushnir, Andrea Weghofer, Qi Wang, Lin Zhang, David F. Albertini & David H. Barad

  2. The Foundation for Reproductive Medicine, New York, NY, 10022, USA

    Norbert Gleicher & David H. Barad

  3. Stem Cell Biology and Molecular Embryology Laboratory, The Rockefeller University, New York, NY, 10065, USA

    Norbert Gleicher

  4. Department of Obstetrics and Gynecology, Wake Forest University, Winston Salem, NC, 27106, USA

    Vitaly A. Kushnir

  5. Department of Obstetrics and Gynecology, Vienna University School of Medicine, Vienna, 1090, Austria

    Norbert Gleicher & Andrea Weghofer

  6. Department of Molecular and Integrative Physiology, The University of Kansas Medical Center, Kansas City, KS, 66160, USA

    David F. Albertini

Authors
  1. Norbert Gleicher
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  2. Sarah K. Darmon
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  3. Vitaly A. Kushnir
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  4. Andrea Weghofer
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  5. Qi Wang
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  6. Lin Zhang
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  7. David F. Albertini
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  8. David H. Barad
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Corresponding author

Correspondence to Norbert Gleicher.

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Conflicts of interest

All authors have read the journal’s policy on disclosure of potential conflicts of interest and have the following disclosures to make: N.G., and D.H.B, are coinventors on a number of pending and already awarded U.S. patents claiming therapeutic benefits from androgen supplementation in women with LFOR and relating to the FMR1 gene in a diagnostic function in female fertility. Both receive royalties from Fertility Nutraceuticals, LLC, in which N.G. also holds shares. N.G., D.H.B, and V.A.K. also are coinventors on three pending AMH-related patent application. They report no other potential conflicts with here reported manuscript. All other authors report no potential conflicts with here reported manuscript.

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Gleicher, N., Darmon, S.K., Kushnir, V.A. et al. How FSH and AMH reflect probabilities of oocyte numbers in poor prognosis patients with small oocyte yields. Endocrine 54, 476–483 (2016). https://doi.org/10.1007/s12020-016-1068-5

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  • DOI: https://doi.org/10.1007/s12020-016-1068-5

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