Relationship Between Anti-Müllerian Hormone and In Vitro Fertilization-Embryo Transfer in Clinical Pregnancy

Abstract

ObjectivesTo retrospectively analyze the correlation between anti-Müllerian hormone (AMH) and the number of oocytes obtained by controlled ovarian hyperstimulation (COH) in women of different ages and explore the factors affecting in vitro fertilization and embryo transfer (IVF-ET) in clinical pregnancy of infertile women to provide evidence for infertile women to choose assisted reproduction strategies.MethodsInfertile women who received IVF-ET or intracytoplasmic sperm injection and embryo transfer (ICSI-ET) treatment in the reproductive center of XX hospital between October 2018 and September 2019 were included. Patient data on medical records, age, body mass index (BMI), years of infertility, basic follicle-stimulating hormone (FSH), basic luteinizing hormone (LH), basic estradiol (E2), anti-Müllerian hormone level (AMH), antral follicle count (AFC), gonadotropins (Gn) medication days, Gn dosage, endometrial thickness on transplantation day, the number of retrieved oocytes, the number of mature oocytes obtained, the number of embryos transferred, clinical pregnancy status, etc., were collected.ResultsA total of 314 patients were enrolled in this study, with an average age of 31.0 ± 4.5 years. The infertility period ranged from 0–21 years. The AMH level showed a downward trend with increasing age. Overall, the AMH level of women of all ages was positively correlated with the number of retrieved oocytes (r = 0.335, p < 0.001). The AMH level of women between 22 and 28 years old was positively correlated with the number of retrieved oocytes (r = 0.164, p < 0.061) but it was not statistically significant. Similarly, the AMH level of women aged 29–35 and 36–43 was positively correlated with the number of retrieved oocytes (r = 0.356, p < 0.001; r = 0.461, p < 0.001). The average age of the pregnant group (30.6 ± 4.4 years) was lower than that of the non-pregnant group (32.2 ± 4.6 years) (p < 0.001). The number of oocytes obtained (9.8 ± 4.5) and the number of embryos transferred (1.9 ± 0.4) in the pregnant group was significantly higher than that in the non-pregnant group (9.2 ± 4.5; 1.7 ± 0.5); the difference was statistically significant. The multivariate logistic regression model showed that age (OR = 0.574 95% CI: 0.350–0.940), AMH (OR = 1.430 95% CI: 1.130–1.820) and the number of oocytes obtained (OR = 1.360 95% CI: 1.030–1.790) were factors affecting clinical pregnancy.ConclusionWe found that the level of AMH in infertile women decreased with age and the number of oocytes obtained in infertile women was positively correlated with AMH. Moreover, the number of oocytes and embryo transferred in the pregnant group was significantly higher than those in the non-pregnant group. Furthermore, age, AMH and the number of oocytes affected the clinical pregnancy.

Machine Learning-Based Modeling of Ovarian Response and the Quantitative Evaluation of Comprehensive Impact Features

“…Besides, our work reveals that the E 2 level on the HCG day (NMIV = 0.951) ranks in second place among all impact features, which matches with the finding that the number of oocytes retrieved increases with the amount of E 2 level on the HCG day [ 29 ], as this feature somehow measures the response of the ovary to the COS and thus indirectly reflects the quality and quantity of the oocyte [ 31 ]. What is more, the NMIV of age is −0.354, meaning that age has a significant effect on the oocyte retrieving No, and the older the woman is, the more difficult it is to retrieve more oocytes in general [ 10 ]. Regarding the AMH, although recent studies claimed it has the highest importance for the ovarian response [ 32 , 33 ], our work confirmed its importance, and the larger the AMH is, the more oocytes it could retrieve in general; however, the status of AMH is weaker as compared to the AFC, E 2 level on the HCG day, and the age.…”

“…Poor ovarian response leads to a high risk of treatment cycles being canceled or a lack of high-quality embryos for transfer. Studies have demonstrated that the impact features, e.g., a women’s clinical information (age, body mass index (BMI), infertility cause, and infertility duration), basal endocrine level (Anti-Müllerian hormone (AMH), basal follicle stimulating hormone (bFSH)), and ultrasound-related index (antral follicle count (AFC)), are closely related to the extent of ovarian response to COS [ 9 , 10 , 11 , 12 , 13 , 14 , 15 ]. The features, such as age, AMH, bFSH, and AFC, etc., are currently recognized as high-impact features related to ovarian reserve function [ 10 , 16 , 17 , 18 ].…”

“…Studies have demonstrated that the impact features, e.g., a women’s clinical information (age, body mass index (BMI), infertility cause, and infertility duration), basal endocrine level (Anti-Müllerian hormone (AMH), basal follicle stimulating hormone (bFSH)), and ultrasound-related index (antral follicle count (AFC)), are closely related to the extent of ovarian response to COS [ 9 , 10 , 11 , 12 , 13 , 14 , 15 ]. The features, such as age, AMH, bFSH, and AFC, etc., are currently recognized as high-impact features related to ovarian reserve function [ 10 , 16 , 17 , 18 ]. As the impact features have their characteristics and interact with each other, it is necessary to formulate a comprehensive and accurate relationship between them and the COS outcome, and this brings about new challenges to clinical practice.…”

The Predictive Levels of Serum Anti-Müllerian Hormone and the Combined Index of the Number of Retrieved Oocytes and Good-Quality Embryos in Advanced-Age Infertile Women

“…Recently, AMH has been used to assess ovarian reserve parameters and response to gonadotrophin stimulation, reproductive outcomes of infertile women [ 4 , 7 – 10 ]. AMH is an emerging and one of the strongest markers of NOR during IVF cycles [ 9 , 11 , 12 ]. Recent studies indicated that AMH could also independently predict pregnancy outcomes [ 13 – 17 ].…”

Comparative Clinical Outcome Following Individualized Follitropin Delta Dosing In Chinese Women Undergoing Ovarian Stimulation For In Vitro Fertilization /Intracytoplasmic Sperm Injection

“…AMH, a paracrine factor implicated in the regulation of early follicular growth, is now widely been used as a quantitative marker of ovarian reserve to predict the response to ovarian stimulation [4,5]. Meanwhile, the recent development of automated AMH assays improved the accuracy and consistency of AMH testing among different in vitro fertilization (IVF) centers [6,7].…”