Advertisement

Current Medical Science

, Volume 38, Issue 5, pp 861–867 | Cite as

Basal Serum Anti-Müllerian Hormone Level as a Predictor of Clinical Outcomes in Freezing-all Embryo Transfer Program

  • Xiao-lan Li
  • Rui Huang
  • Cong Fang
  • Xiao-yan LiangEmail author
Article
  • 19 Downloads

Abstract

As a novel biomarker, there is inconsistent evidence regarding the association between anti-Müllerian hormone (AMH) and live birth rate in freezing-all embryo transfer cycles. We aim to assess the prognostic effect of baseline AMH on clinical outcomes, especially live birth rate in freezing-all embryo transfer cycles. A total of 828 non-polycystic ovary patients that underwent their first frozen-thawed embryo transfers in our center between January 2010 and January 2015 were recruited in this retrospective analysis. Patients were stratified into three groups based on their baseline AMH concentration: low AMH group (<1.4 ng/mL), middle AMH group (1.4–5.8 ng/mL) and high AMH group (>5.8 ng/mL). The results showed that low AMH level was associated with adverse clinical outcomes. The differences in implantation rate (21.9% vs. 43.2% vs. 58.8%, P<0.001), clinical pregnancy rate (32.0% vs. 55.2% vs. 65.7%, P<0.001), live birth delivery rate (21.8% vs. 43.6% vs. 52.7%, P<0.001) and miscarriage rate (31.8% vs. 17.5% vs. 15.4%, P=0.014) among the three groups were statistically significant. After adjusting confounders (i.e. age, baseline FSH level, AFC, endometrium thickness, endometrium preparation protocols, number of embryos transferred, etiologies of infertility), differences in live birth rate, clinical pregnancy rate and implantation rate between groups remained significant. The further age subgroup analysis demonstrated that low AMH concentration was significantly associated with poor outcomes both in young and advanced patients. The area under the curve for serum AMH, age, AFC and FSH were 0.635, 0.634, 0.615 and 0.543 respectively, for predicting live birth. In conclusion, baseline AMH was an independent prognostic factor of live birth rate of freezing-all embryo transfers, but its predictive value on live birth rate was of limited clinical value.

Key words

anti-Müllerian hormone freezing-all embryo transfer live birth rate 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Rini M, Magnes BZ, Pines E, et al. Fresh embryo transfer versus frozen embryo transfer in in vitro fertilization cycles: a systematic review and metaanalysis. J Fertil Steril, 2013,99(1):156–162CrossRefGoogle Scholar
  2. 2.
    Shapiro BS, Daneshmand ST, Garner FC, et al. Evidence of impaired endometrial receptivity after ovarian stimulation for in vitro fertilization: a prospective randomized trial comparing fresh and frozen-thawed embryo transfers in high responders. J Fertil Steril, 2011,96(2):516–518CrossRefGoogle Scholar
  3. 3.
    Kansal KS, Ratcliffe SJ, Milman L, et al. Perinatal morbidity after in vitro fertilization is lower with frozen embryo transfer. J Fertil Steril, 2011,95(2):548–553CrossRefGoogle Scholar
  4. 4.
    Sazonova A, Kllen K, Thurin-Kjellberg A, et al. Obstetric outcome in singletons after in vitro fertilization with cryopreserved/thawed embryos. J Hum Reprod, 2012,27(5):1343–1350CrossRefGoogle Scholar
  5. 5.
    Borini A, Cattoli M, Bulletti C, et al. Clinical efficiency of oocyte and embryo cryopreservation. J Ann N YAcad Sci, 2010,1127(1):49–58CrossRefGoogle Scholar
  6. 6.
    Roque M. Freeze-all policy: is it time for that? J Assist Reprod Genet, 2014,32(2):171–176CrossRefGoogle Scholar
  7. 7.
    Josso N, Cate RL, Picard JY, et al. Anti-müllerian hormone: the Jost factor. Recent Prog Horm Res, 1993,48(1):1–59Google Scholar
  8. 8.
    Cate RL, Mattaliano RJ, Hession C, et al. Isolation of the bovine and human genes for Müllerian inhibiting substance and expression of the human gene in animal cells. J Cell, 1986,45(5):685–698CrossRefGoogle Scholar
  9. 9.
    da Silva AL, Even M, Grynberg M, et al. Anti-Müllerian hormone: player and marker of folliculogenesis. Gynecol Obstet Fertil (French), 2010,38(7–8):471CrossRefGoogle Scholar
  10. 10.
    Laven JS, Mulders AG, Visser JA, et al. Anti-Müllerian hormone serum concentrations in normoovulatory and anovulatory women of reproductive age. J Clin Endocrinol Metab, 2004,89(1):318–323CrossRefGoogle Scholar
  11. 11.
    Modi D, Bhartiya D, Puri C. Developmental expression and cellular distribution of Mullerian inhibiting substance in the primate ovary. J Reprod, 2006,132(3):443–453CrossRefGoogle Scholar
  12. 12.
    Baarends WM, Hoogerbrugge JW, Post M, et al. Antimullerian hormone and anti-mullerian hormone type IIreceptor messenger ribonucleic acid expression during postnatal testis development and in the adult testis of the rat. J Endocrinology, 1995,136(12):5614–5622CrossRefGoogle Scholar
  13. 13.
    La MA, Broekmans FA. Anti-Müllerian hormone (AMH): what do we still need to know? J Hum Reprod, 2009,24(9):2264–2275CrossRefGoogle Scholar
  14. 14.
    Dewailly D, Andersen CY, Balen A, et al. The physiology and clinical utility of anti-Müllerian hormone in women. J Hum Reprod Update, 2014,20(3):370CrossRefGoogle Scholar
  15. 15.
    Ebner T, Sommergruber M, Moser M, et al. Basal level of anti-Müllerian hormone is associated with oocyte quality in stimulated cycles. J Hum Reprod, 2006,21(8):2022–2026CrossRefGoogle Scholar
  16. 16.
    Smeenk JM, Sweep FC, Zielhuis GA, et al. Antimüllerian hormone predicts ovarian responsiveness, but not embryo quality or pregnancy, after in vitro fertilization or intracyoplasmic sperm injection. J Fertil Steril, 2007,87(1):223–226CrossRefGoogle Scholar
  17. 17.
    Fong SL, Baart EB, Martini E, et al. Anti-Müllerian hormone: a marker for oocyte quantity, oocyte quality and embryo quality? J Reprod Biomed Online, 2008,16(5):664–670CrossRefGoogle Scholar
  18. 18.
    Lekamge DN, Barry M, Kolo M, et al. Anti-Müllerian hormone as a predictor of IVF outcome. J Reprod Biomed Online, 2007,14(5):602–610CrossRefGoogle Scholar
  19. 19.
    Iliodromiti S, Kelsey TW, Wu O, et al. The predictive accuracy of anti-Müllerian hormone for live birth after assisted conception: a systematic review and meta-analysis of the literature. J Hum Reprod Update, 2014,20(4):560–570CrossRefGoogle Scholar
  20. 20.
    Tal R, Tal O, Seifer BJ, et al. Anti-mullerian hormone (AMH) as a predictor of implantation and clinical pregnancy following art: a meta-analysis. Fertil Steril, 2014,102(3):e337–e337CrossRefGoogle Scholar
  21. 21.
    Steer CV, Mills CL, Tan SL, et al. The cumulative embryo score: a predictive embryo scoring technique to select the optimal number of embryos to transfer in an in-vitro fertilization and embryo transfer programme. J Hum Reprod, 1992,7(1):117CrossRefGoogle Scholar
  22. 22.
    Zegers-Hochschild F, Adamson GD, Mouzon JD, et al. International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) Revised glossary of ART terminology, 2009. J Fertil Steril, 2009,92(5):1520–1524CrossRefGoogle Scholar
  23. 23.
    Modi D, Bhartiya D, Puri C. Developmental expression and cellular distribution of Müllerian inhibiting substance in the primate ovary. J Reproduction, 2006,132(3):443–453CrossRefGoogle Scholar
  24. 24.
    La Marca A, Stabile G, Artenisio AC, et al. Serum anti-Mullerian hormone throughout the human menstrual cycle. J Hum Reprod, 2006,21(12):3103–3107CrossRefGoogle Scholar
  25. 25.
    Hehenkamp WJ, Looman CW, Themmen AP, et al. Anti-Müllerian hormone levels in the spontaneous menstrual cycle do not show substantial fluctuation. J Clin Endocrinol Metab, 2006,91(10):4057–4063CrossRefGoogle Scholar
  26. 26.
    Tsepelidis S, Devreker F, Demeestere I, et al. Stable serum levels of anti-Müllerian hormone during the menstrual cycle: a prospective study in normoovulatory women. J Hum Reprod, 2007,22(7):1837–1840CrossRefGoogle Scholar
  27. 27.
    Nelson SM, Yates RW, Fleming R. Serum anti-Müllerian hormone and FSH: prediction of live birth and extremes of response in stimulated cycles— implications for individualization of therapy. J Hum Reprod, 2007,22(9):2414–2421CrossRefGoogle Scholar
  28. 28.
    Eldargeva T, Benchetrit A, Spitz IM, et al. Dynamic assays of inhibin B, anti-Mullerian hormone and estradiol following FSH stimulation and ovarian ultrasonography as predictors of IVF outcome. Hum Reprod, 2005,20(11):3178–3183CrossRefGoogle Scholar
  29. 29.
    Lehmann P, Vélez MP, Saumet J, et al. Anti-Müllerian hormone (AMH): a reliable biomarker of oocyte quality in IVF. J Assist Reprod Genet, 2014,31(4):493–498CrossRefGoogle Scholar
  30. 30.
    van Rooij IA, Broekmans FJ, Hunault CC, et al. Use of ovarian reserve tests for the prediction of ongoing pregnancy in couples with unexplained or mild male infertility. J Reprod Biomed Online, 2006,12(2):182–190CrossRefGoogle Scholar
  31. 31.
    Broekmans FJ, Kwee J, Hendriks DJ, et al. A systematic review of tests predicting ovarian reserve and IVF outcome. J Hum Reprod Update, 2006,12(6):685–718CrossRefGoogle Scholar
  32. 32.
    Hagen CP, Vestergaard S, Juul MA, et al. Low concentration of circulating antimüllerian hormone is not predictive of reduced fecundability in young healthy women: a prospective cohort study. J Fertil Steril, 2012,98(6):1602–1608CrossRefGoogle Scholar
  33. 33.
    Mitwally MF, Bhakoo HS, Crickard K, et al. Estradiol production during controlled ovarian hyperstimulation correlates with treatment outcome in women undergoing in vitrofertilization-embryo transfer. J Fertil Steril, 2006,86(3):588–596CrossRefGoogle Scholar
  34. 34.
    Chai J, Lee KF, Ng EH, et al. Ovarian stimulation modulates steroid receptor expression and spheroid attachment in peri-implantation endometria: studies on natural and stimulated cycles. J Fertil Steril, 2011,96(3):764–768CrossRefGoogle Scholar
  35. 35.
    Sse A, Bungum LJ, Giwercman A, et al. Antimüllerian hormone levels are associated with live birth rates in ART, but the predictive ability of antimüllerian hormone is modest. J Eur J Obstet Gynecol Reprod Biol, 2018:199–204Google Scholar
  36. 36.
    Li HW, Lee VC, Lau EY, et al. Role of baseline antral follicle count and anti-Müllerian hormone in the index stimulation cycle of IVF treatment in predicting outcome of subsequent frozen-thawed embryo transfers. J Gynecol Endocrinol, 2014,30(7):490–493CrossRefGoogle Scholar
  37. 37.
    Broer SL, Disseldorp JV, Broeze KA, et al. Added value of ovarian reserve testing on patient characteristics in the prediction of ovarian response and ongoing pregnancy: an individual patient data approach. J Hum Reprod Update, 2013,19(1):26–36CrossRefGoogle Scholar
  38. 38.
    Bancsi LF, Broekmans FJ, Eijkemans MJ, et al. Predictors of poor ovarian response in in vitro fertilization: a prospective study comparing basal markers of ovarian reserve. J Fertil Steril, 2002,77(2):328–336CrossRefGoogle Scholar
  39. 39.
    Oehninger S, Nelson SM, Verweij P, et al. Predictive factors for ovarian response in a corifollitropin alfa/ GnRH antagonist protocol for controlled ovarian stimulation in IVF/ICSI cycles. J Reprod Biol Endocrinol, 2015,13:117CrossRefGoogle Scholar
  40. 40.
    Lekamge DN, Barry M, Kolo M, et al. Anti-Müllerian hormone as a predictor of IVF outcome. J Reprod Biomed Online. 2007,14(5):602–610CrossRefGoogle Scholar
  41. 41.
    Boomsma CM, Macklon NS. What can the clinician do to improve implantation? J Reprod Biomed Online, 2006,14(6):27–37Google Scholar

Copyright information

© Huazhong University of Science and Technology 2018

Authors and Affiliations

  • Xiao-lan Li
    • 1
  • Rui Huang
    • 1
  • Cong Fang
    • 1
  • Xiao-yan Liang
    • 1
    Email author
  1. 1.Reproductive Medicine Research Center, Sixth Affiliated HospitalSun Yat-sen UniversityGuangzhouChina

Personalised recommendations