Skip to main content
SpringerLink
Log in

Different ovarian response by age in an anti-Müllerian hormone-matched group undergoing in vitro fertilization

Journal of Assisted Reproduction and Genetics volume 29, pages 117–125 (2012)Cite this article

Abstract

Background

Recently, serum anti-Müllerian hormone (AMH) has been used as a good marker of ovarian response during in vitro fertilization (IVF). However, in the clinical setting, we felt that ovarian response was clearly different by age with the same AMH level. Then in this study we evaluated the relationship between serum AMH, age and parameters related to ovarian response and compared these parameters in regard to age within serum AMH-matched group.

Methods and results

The relationship of these parameters were evaluated retrospectively in patients undergoing their first IVF cycle under a GnRH agonist flare up protocol (n = 456) between October 2008 and October 2010 in our clinic. To understand the relations between variables described above, principal component analysis (PCA) was performed. PCA revealed patients’ age was at the different dimension from serum AMH and other variables. Therefore at first we segregated all patients into Low, Normal and High responder groups by their serum AMH using cut-off value of receiver operator characteristics curve analysis. Secondary, we divided each responder group into four subgroups according to patients’ age. The high aged subgroups required a significantly higher dose of gonadotropin and a longer duration of stimulation; however, they had significantly lower peak E2 and a smaller number of total oocytes as well as M2 oocytes compared to the low aged subgroups.

Conclusions

The influence of aging on the ovarian response was clearly seen in all groups; the ovarian response tended to decrease as patients’ age increased with the same AMH level. Therefore serum AMH in combination with age is a better indicator than AMH alone.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Fig. 1

We’re sorry, something doesn't seem to be working properly.

Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.

References

  1. Pellicer A, Simon C, Remohi J. Effects of aging on the female reproductive system. Hum Reprod. 1995;10 Suppl 2:77–83.

    PubMed  CAS  Google Scholar 

  2. Toner JP, Flood JT. Fertility after the age of 40. Obstet Gynecol Clin North Am. 1993;20:261–72.

    PubMed  CAS  Google Scholar 

  3. El-Toukhy T, Khalaf Y, Hart R, Taylor A, Braude P. Young age does not protect against the adverse effects of reduced ovarian reserve–an eight year study. Hum Reprod. 2002;17:1519–24.

    Article  PubMed  Google Scholar 

  4. Cahill DJ, Prosser CJ, Wardle PG, Ford WC, Hull MG. Relative influence of serum follicle stimulating hormone, age and other factors on ovarian response to gonadotrophin stimulation. Br J Obstet Gynaecol. 1994;101:999–1002.

    Article  PubMed  CAS  Google Scholar 

  5. Sharif K, Elgendy M, Lashen H, Afnan M. Age and basal follicle stimulating hormone as predictors of in vitro fertilisation outcome. Br J Obstet Gynaecol. 1998;105:107–12.

    Article  PubMed  CAS  Google Scholar 

  6. Ng EH, Tang OS, Ho PC. The significance of the number of antral follicles prior to stimulation in predicting ovarian responses in an IVF programme. Hum Reprod. 2000;15:1937–42.

    Article  PubMed  CAS  Google Scholar 

  7. Hendriks DJ, Mol BW, Bancsi LF, Te Velde ER, Broekmans FJ. Antral follicle count in the prediction of poor ovarian response and pregnancy after in vitro fertilization: a meta-analysis and comparison with basal follicle-stimulating hormone level. Fertil Steril. 2005;83:291–301.

    Article  PubMed  Google Scholar 

  8. Broekmans FJ, Kwee J, Hendriks DJ, Mol BW, Lambalk CB. A systematic review of tests predicting ovarian reserve and IVF outcome. Hum Reprod Update. 2006;12:685–718.

    Article  PubMed  CAS  Google Scholar 

  9. Ficicioglu C, Kutlu T, Baglam E, Bakacak Z. Early follicular antimullerian hormone as an indicator of ovarian reserve. Fertil Steril. 2006;85:592–6.

    Article  PubMed  CAS  Google Scholar 

  10. Nakhuda GS, Sauer MV, Wang JG, Ferin M, Lobo RA. Mullerian inhibiting substance is an accurate marker of ovarian response in women of advanced reproductive age undergoing IVF. Reprod Biomed Online. 2007;14:450–4.

    Article  PubMed  CAS  Google Scholar 

  11. Gnoth C, Schuring AN, Friol K, Tigges J, Mallmann P, Godehardt E. Relevance of anti-Mullerian hormone measurement in a routine IVF program. Hum Reprod. 2008;23:1359–65.

    Article  PubMed  CAS  Google Scholar 

  12. Kwee J, Schats R, McDonnell J, Themmen A, de Jong F, Lambalk C. Evaluation of anti-Mullerian hormone as a test for the prediction of ovarian reserve. Fertil Steril. 2008;90:737–43.

    Article  PubMed  CAS  Google Scholar 

  13. Lee MM, Donahoe PK, Hasegawa T, Silverman B, Crist GB, Best S, Hasegawa Y, Noto RA, Schoenfeld D, MacLaughlin DT. Mullerian inhibiting substance in humans: normal levels from infancy to adulthood. J Clin Endocrinol Metab. 1996;81:571–6.

    Article  PubMed  CAS  Google Scholar 

  14. Themmen AP. Anti-Mullerian hormone: its role in follicular growth initiation and survival and as an ovarian reserve marker. J Natl Cancer Inst Monogr 2005;18–21.

  15. Visser JA, Durlinger AL, Peters IJ, van den Heuvel ER, Rose UM, Kramer P, de Jong FH, Themmen AP. Increased oocyte degeneration and follicular atresia during the estrous cycle in anti-Mullerian hormone null mice. Endocrinology. 2007;148:2301–8.

    Article  PubMed  CAS  Google Scholar 

  16. La Marca A, Stabile G, Artenisio AC, Volpe A. Serum anti-Mullerian hormone throughout the human menstrual cycle. Hum Reprod. 2006;21:3103–7.

    Article  PubMed  Google Scholar 

  17. Streuli I, Fraisse T, Pillet C, Ibecheole V, Bischof P, de Ziegler D. Serum antimullerian hormone levels remain stable throughout the menstrual cycle and after oral or vaginal administration of synthetic sex steroids. Fertil Steril. 2008;90:395–400.

    Article  PubMed  CAS  Google Scholar 

  18. Muttukrishna S, Suharjono H, McGarrigle H, Sathanandan M. Inhibin B and anti-Mullerian hormone: markers of ovarian response in IVF/ICSI patients? BJOG. 2004;111:1248–53.

    Article  PubMed  CAS  Google Scholar 

  19. Lee TH, Liu CH, Huang CC, Wu YL, Shih YT, Ho HN, Yang YS, Lee MS. Serum anti-Mullerian hormone and estradiol levels as predictors of ovarian hyperstimulation syndrome in assisted reproduction technology cycles. Hum Reprod. 2008;23:160–7.

    Article  PubMed  CAS  Google Scholar 

  20. Reber RW. Puberty: Treatment of Amenorrhea. Berek and Novak’s Gynecology. 14th ed. In: Berek JS, editors. Lippincott Williams and Wilkins; 2006. p. 1045–1046

  21. Honnma H, Hashiba Y, Asada Y, Endo T. Failure of triggering oocyte maturation with a GnRH agonist in polycystic ovary syndrome: two case reports. Eur J Obstet Gynecol Reprod Biol. 2011;157: 239–40.

    Article  PubMed  Google Scholar 

  22. Van Vaerenbergh I, Van Lommel L, Ghislain V, In’t Veld P, Schuit F, Fatemi HM, Devroey P, Bourgain C. In GnRH antagonist/rec-FSH stimulated cycles, advanced endometrial maturation on the day of oocyte retrieval correlates with altered gene expression. Hum Reprod. 2009;24:1085–91.

    Article  PubMed  Google Scholar 

  23. Akobeng AK. Understanding diagnostic tests 3: receiver operating characteristic curves. Acta Paediatr. 2007;96:644–7.

    Article  PubMed  Google Scholar 

  24. La Marca A, Sighinolfi G, Radi D, Argento C, Baraldi E, Artenisio AC, Stabile G, Volpe A. Anti-Mullerian hormone (AMH) as a predictive marker in assisted reproductive technology (ART). Hum Reprod Update. 16:113–30.

  25. Singer T, Barad DH, Weghofer A, Gleicher N. Correlation of antimullerian hormone and baseline follicle-stimulating hormone levels. Fertil Steril. 2009;91:2616–9.

    Article  PubMed  CAS  Google Scholar 

  26. Meldrum DR. Female reproductive aging–ovarian and uterine factors. Fertil Steril. 1993;59:1–5.

    PubMed  CAS  Google Scholar 

  27. Nelson SM, Yates RW, Lyall H, Jamieson M, Traynor I, Gaudoin M, Mitchell P, Ambrose P, Fleming R. Anti-Mullerian hormone-based approach to controlled ovarian stimulation for assisted conception. Hum Reprod. 2009;24:867–75.

    Article  PubMed  CAS  Google Scholar 

  28. Reichman DE, Missmer SA, Berry KF, Ginsburg ES, Racowsky C. Effect of time between human chorionic gonadotropin injection and egg retrieval is age dependent. Fertil Steril. 2011;95:1990–5.

    Article  PubMed  CAS  Google Scholar 

  29. Seifer DB, Baker VL, Leader B. Age-specific serum anti-Mullerian hormone values for 17,120 women presenting to fertility centers within the United States. Fertil Steril. 2011;95:747–50.

    Article  PubMed  CAS  Google Scholar 

  30. Shebl O, Ebner T, Sir A, Schreier-Lechner E, Mayer RB, Tews G, Sommergruber M. Age-related distribution of basal serum AMH level in women of reproductive age and a presumably healthy cohort. Fertil Steril. 2011;95:832–4.

    Article  PubMed  CAS  Google Scholar 

  31. Tarlatzis BC, Zepiridis L, Grimbizis G, Bontis J. Clinical management of low ovarian response to stimulation for IVF: a systematic review. Hum Reprod Update. 2003;9:61–76.

    Article  PubMed  CAS  Google Scholar 

  32. Engmann L, Siano L, Schmidt D, Nulsen J, Maier D, Benadiva C. GnRH agonist to induce oocyte maturation during IVF in patients at high risk of OHSS. Reprod Biomed Online. 2006;13:639–44.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgement

All authors have no conflict of interest. We thank the expert technical help of nursing and embryology staff of Asada Ladies’ clinic.

Author information

Authors and Affiliations

  1. Asada Ladies’ Clinic, RENAK 5 F, Matsushincho 1-4, Kasugai, Aichi, 486-0931, Japan

    Hiroyuki Honnma, Masahiro Sasaki, Yoshiki Hashiba, Hisanori Oguri, Takanori Fukunaga & Yoshimasa Asada

  2. Department of Obstetrics and Gynecology, Sapporo Medical University, School of Medicine, South 1 West 16, Chuo-ku, Sapporo, 060-8543, Japan

    Tsuyoshi Baba & Toshiaki Endo

Authors
  1. Hiroyuki Honnma
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tsuyoshi Baba
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Masahiro Sasaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yoshiki Hashiba
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hisanori Oguri
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Takanori Fukunaga
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Toshiaki Endo
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Yoshimasa Asada
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hiroyuki Honnma.

Additional information

Capsule

Ovarian response was significantly different by age within AMH-matched groups; serum AMH in combination with age was more predictable ovarian response than AMH alone.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Honnma, H., Baba, T., Sasaki, M. et al. Different ovarian response by age in an anti-Müllerian hormone-matched group undergoing in vitro fertilization. J Assist Reprod Genet 29, 117–125 (2012). https://doi.org/10.1007/s10815-011-9675-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10815-011-9675-9

Keyword

search

Navigation