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What is the optimal threshold of serum Anti-Müllerian hormone (AMH) necessary for IVM treatments?

  • ASSISTED REPRODUCTION TECHNOLOGIES
  • Published:
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Abstract

Purpose

To assesse circulating levels of Anti-Müllerian hormone (AMH) as a predictor of oocyte number and their potential to mature in vitro in both normo-ovulatory (NO) women and in women with Polycystic Ovary Syndrome (PCOS) undergoing in vitro maturation (IVM) treatments.

Methods

We prospectively studied NO women and women diagnosed with PCOS, (age range 21–39 years) underwent IVM treatments at our center. Serum AMH levels were quantified before each cycle and correlated to oocytes number, maturation and fertilization during in vitro maturation.

Results

104 NO and 30 PCOS IVM cycles were followed with retrieval of a total of 672 and 491 oocytes, respectively. In NO women, the serum AMH level positively correlated with the number of oocytes retrieved, (R = 0.6; P <0.0001) the number of M2 oocytes at 24 and 48 h (R = 0.4; P <0.01; R = 0.26 p < 0.007, respectively) and with the total number of M2 oocytes (R = 0.47; P < 0.0001). In the PCOS group, the serum AMH level positively correlated only with the number of oocytes retrieved (R = 0.43; P <0.03). Receiver operating characteristic (ROC) analyses showed that a cutoff AMH level of 1.56 (ng/ml) could identify patients with 5 or more oocytes at OPU with a sensitivity of 83 % and a specificity of 75 %. An AMH level of 1.63 (ng/ml) was the threshold for 5 or more matured oocytes (sensitivity = 81 %, specificity = 53 %).

Conclusions

Serum AMH may be used as a marker to identify candidates for IVM treatment in both NO and PCOS women.

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Acknowledgments

The authors are greatly indebted to Prof. Andrew Zbar of MEDEDIT, Sheba Medical Center for the English editing.

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Authors and Affiliations

  1. IVF Unit, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Ramat-Gan, affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

    Alon Kedem, Gil M. Yerushalmi, Ettie Maman & Ariel Hourvitz

  2. Institute of Endocrinology, Sheba Medical Center, and Tel Hashomer, affiliated with the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel

    Rina Hemi & Mirit Hanochi

  3. IVF Unit, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, 52621, Israel

    Alon Kedem

Authors
  1. Alon Kedem
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  2. Gil M. Yerushalmi
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  3. Ettie Maman
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  4. Rina Hemi
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  5. Mirit Hanochi
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  6. Ariel Hourvitz
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Corresponding author

Correspondence to Alon Kedem.

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Capsule

The identification of cycles able to produce numerous oocytes will considerably improve the efficiency of IVM treatments. We would suggest that an AMH cut‐off concentration could guide the appropriateness of IVM therapy in selected cases, reducing the number of recruited cycles where suboptimal oocyte numbers are likely to be retrieved.

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Kedem, A., Yerushalmi, G.M., Maman, E. et al. What is the optimal threshold of serum Anti-Müllerian hormone (AMH) necessary for IVM treatments?. J Assist Reprod Genet 30, 745–751 (2013). https://doi.org/10.1007/s10815-013-9996-y

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  • DOI: https://doi.org/10.1007/s10815-013-9996-y

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