Prognostic indicators of assisted reproduction technology outcomes of cycles with ultralow serum antimüllerian hormone: a multivariate analysis of over 5,000 autologous cycles from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System database for 2012–2013

Abstract

Refusing treatment solely on the basis of ultralow AMH levels is not advisable, but patients should be counseled appropriately about the prognostic factors for cancellation and outcomes.

Fertility in women of late reproductive age: the role of serum anti-Müllerian hormone (AMH) levels in its assessment

“…Reicheman et al [ 74 ] found 3.9 % clinical pregnancy rate in women with AMH <0.17 ng/ml and >42 years. Seifer et al [ 75 ] conducted the largest study in this area analyzing AMH concentrations in over 5000 cycles from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System Database for 2012–2013. According to their data, the cycles of women with the AMH concentration lower than 0.16 ng/mL had a greatest risk of cancelation.…”

“…The different results in all above studies could be partially explained by different assays applied in different years [ 75 ]. In addition, even the similar kits achieved higher or lower values during the same time.…”

Ovarian reserve testing: a user’s guide

“…4 However, despite its strong correlation with ovarian response to stimulation in ART, AMH is a poor predictor of nonpregnancy with sensitivities between 19-66%, and specificities between 55-89% when using cut-offs ranging from <0.1-1.66 ng/mL (Table 1). 3 Notably, a recent study of the Society for Assisted Reproductive Technology database found that while women with ultralow AMH (<0.16 ng/ mL) had 54% cycle cancellation rate, the overall live birth rate per cycle start was 9.5%, 43 supporting the notion that denying infertility treatment solely on the basis of undetectable AMH is not advisable. Similarly, AMH is a poor predictor of pregnancy and live birth following ART, with 2 recent meta-analyses showing the AUC for AMH as predictor of clinical pregnancy and live birth to be 0.63 and 0.61, respectively.…”

Anti-müllerian hormone as an fertility indicator in women of late reproductive age

“…D. Seifer и соавт. [23] провели самое крупное исследование в этой области, проанализировав концентрацию АМГ в более чем 5000 циклах из базы данных системы отчетов об итогах клинических исследований в области ВРТ за 2012-2013 гг. По их данным, пациентки с уровнем АМГ <0,16 нг/мл имели наибольший риск отмены цикла ЭКО.…”

“…Важно отметить, что авторам не удалось установить определенный пороговый уровень АМГ, ниже которого беременность была бы исключена. Разница в результатах вышеприведенных исследований может быть частично объяснена применением различных методов оценки концентрации АМГ [23,28]. К сожалению, имеющиеся методы оценки не позволяют надежно предсказать исход лечения бесплодия у пациенток позднего репродуктивного возраста с низкими значениями АМГ, особенно у женщин старше 42 лет.…”