Anti-Müllerian hormone (AMH): a reliable biomarker of oocyte quality in IVF
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To evaluate the impact of serum AMH levels on stimulated IVF implantation and clinical pregnancy rates.
• Design: Retrospective study with multivariate analysis.
• Setting: Clinique ovo (Montreal University affiliated Center).
• Patient(s): Six hundred and thirty seven patients undergoing a stimulated IVF protocol were included. Only non-polycystic ovary patients at their first IVF attempt were considered for the analysis.
• Intervention(s): None.
• Main outcome measures(s): Implantation and ongoing pregnancy rates.
Cycle outcomes were analysed according to AMH percentiles based on the AMH normogram per patient’s age of our infertile population. Multivariate analyses were done to adjust for potential confounding factors such as age, total exogenous FSH dosage and number of eggs retrieved. Compared to the reference population, a significant lower mean implantation rate (0.26 vs 0.45) was observed in patients under 35 years of age with AMH < 1 ng/ml. Women with AMH < 25th percentile had less chances of having an embryo transferred, lower chances of having an ongoing pregnancy per started IVF cycle and a lower embryo freezing rate compared to the reference population.
Patients with AMH < 0.47 ng/ml should be advised before starting a stimulated IVF cycle of the poorer prognosis compared to our reference population independently of their age, total exogenous FSH dosage and number of eggs retrieved. Therefore, AMH could enable a more individualized number of embryo transfer policy based on oocyte quality.