Anti-Mullerian hormone concentrations in individual follicular fluids within one stimulated IVF cycle resemble blood serum values

Abstract

PurposeAnti-Mullerian hormone (AMH) is commonly known as the most potent marker for ovarian reserve due to its decline as female age increases. While serum AMH (sAMH) levels have been intensively investigated, there is less data regarding AMH concentrations in follicular fluid (FF), since FF has usually been designated as waste product during oocyte collection in assisted reproductive technologies. This pilot study investigated follicle AMH concentrations (fAMH) of several follicles per ovary, individually collected with the Steiner-Tan needle, and compared them to sAMH concentrations in women undergoing IVF treatment. We hypothesized that there is no difference of fAMH concentrations in individual follicles and that these concentrations resemble the sAMH value of the patient.MethodsPatients were stimulated with a gonadotropin-releasing hormone antagonist ovarian hyperstimulation protocol. On the day of oocyte retrieval, serum samples and FF from all individual follicles from one stimulated IVF cycle were collected and individually analyzed for AMH concentrations.ResultsIntracyclic mean fAMH values (n follicle = 2–14) were significantly correlated to sAHM values (ρ = 0.85, p < 0.001) and showed a trend to be negatively associated with age (ρ = −0.43, p = 0.06). Mean intrapatient fAMH concentrations differed significantly (p < 0.001). Furthermore, significant correlations of sAMH with individual fAMH values of the first five follicles of each patient were observed.ConclusionsIn conclusion, our results clearly showed that individual fAMH concentrations reflected sAMH values and that fAMH concentrations did not significantly differ within one patient. In future studies, it will be interesting to correlate individual fAMH values to the respective embryo development and overall pregnancy outcome in order to improve IVF treatments and to refrain from embryo overproduction.

Endometriosis accelerates synchronization of early embryo cell divisions but does not change morphokinetic dynamics in endometriosis patients

“…Ovarian hyperstimulation was performed as previously described [18]. Briefly, patients received controlled ovarian stimulation with gonadotropin-releasing hormone (GnRH) antagonist protocol.…”

“…Oocyte retrieval was performed using a Steiner-Tan needle 17 gauge and a Steiner flush/valve (IVFETFLEX.com HandelsgmbH & Co KG, Graz, Austria) 35 hours after administering 5,000–10,000 IU human chorionic gonadotropin (Pregnyl, Merck Sharp & Dohme Ges.m.b.H., Vienna, Austria) [19]. Oocytes were processed under constant conditions of 37°C in an IVF workstation L24E with an included heating stage (K-SYSTEMS Kivex Biotec A/S, Birkerod, Denmark) as previously described [18]. ICSI was performed in all oocytes of both groups (endometriosis and control).…”

Impact of polar body biopsy on embryo morphokinetics—back to the roots in preimplantation genetic testing?

“…Oocyte retrieval was performed as previously described by Schenk and coworkers [ 13 ]. Briefly, follicles larger than 10 mm in diameter were aspirated and flushed (Flushing medium GM501 Flush; Gynemed Medizinprodukte GmbH & Co. KG) under sedation (Propofol, Fresenius Kabi Austria GmbH; Rapifen, Janssen-Cilag Pharma GmbH) and transvaginal ultrasound guidance (GE Healthcare Austria GmbH) with a Steiner-Tan needle 17 gauge and a Steiner flush/valve ( IVFETFLEX.com , HandelsgmbH & Co KG).…”

The role of anti-Müllerian hormone (AMH) in ovarian disease and infertility

“…The AMH secretion begins again with the recruitment of follicles with the maximal concentration of AMH at the average age of 24.5 years. The plateau phase usually begins around the age of 25 years, and then the concentration of AMH gradually decreases until menopause [1,36,37].…”