The predictive value of anti-mullerian hormone on embryo quality, blastocyst development, and pregnancy rate following in vitro fertilization-embryo transfer (IVF-ET)

Abstract

Purpose The objective of this study was to investigate the predictive value of anti-Mullerian hormone (AMH) on fertilization rate (FR), blastocyst development, embryo quality, the outcome of the pregnancy and the live birth rate (LBR) following in vitro fertilization-embryo transfer (IVF-ET) /intracytoplasmic sperm injection (ICSI). Method In this prospective study outcomes were followed in 83 women undergoing cycles of IVF/ICSI within a university hospital. Basal serum AMH, follicle stimulating hormone (FSH), luteinizing hormone (LH) and antral follicle count (AFC) were measured on Day 3. Serum AMH (Gn6 AMH ) level was measured on Day 6 after the administration of gonadotrophin (Gn). AMH was measured in follicle fluid (FF AMH) on the day of ovum pick-up (dOPU). The numbers of retrieved and fertilized oocytes, good quality embryos and blastocysts were counted. Secondary outcome variables included clinical pregnancy rate (CPR) and LBR. Results Spearman correlation analysis indicated that the numbers of oocytes, good quality embryos and blastocysts were associated with AMH (P<0.05) and that LBR was correlated with FF AMH (r=0.495, P<0.05). No associations were found between FR and AMH (P>0.05). Receiver operating characteristic analysis showed that the sensitivity of FF AMH at predicting CPR was 91.2 %; the specificity was 86.5 % and ROC AUC was 0.893 (P<0.0001). Conclusion AMH parameters were correlated with good quality embryos and blastocysts, but only FF AMH showed a significant correlation with LBR and CPR.

Mitochondrial SIRT5 is present in follicular cells and is altered by reduced ovarian reserve and advanced maternal age

“…In our study, young women with reduced ovarian reserve had a 23% decrease in pregnancy rates compared with young women with normal ovarian reserve. Similar studies have shown an association between reduced ovarian reserve and reduced pregnancy rates (Hazout et al 2004;Lekamge et al 2007;Wunder et al 2008;Brodin et al 2013;Hattori et al 2013;Honnma et al 2013;Li et al 2013;Lin et al 2013). Perturbations in post-translational modifications of proteins by SIRT5 may be contributing to the decline in oocyte viability that is seen in women with reduced ovarian reserve or women of advanced maternal age by altering key metabolic pathways.…”

Assessing ovarian response: antral follicle count versus anti-Müllerian hormone

“…A recent prospective study in nearly 900 women undergoing 1230 IVF cycles confirmed these findings, reporting that AMH level is strongly associated with both pregnancy and live birth rates, independent of age and oocyte yield (Brodin et al, 2013). However, other studies have not shown an association between AMH level and pregnancy rates or live births (Kedem et al, 2013;Lin et al, 2013;Mutlu et al, 2013;Reichman et al, 2014), including two separate metaanalyses (Broer et al, 2013;Iliodromiti et al, 2014b). A third meta-analysis found a weak association between AMH level and implantation and clinical pregnancy rates (Tal et al, 2015).…”

Antimüllerian hormone as a predictor of good-quality supernumerary blastocyst cryopreservation among women with levels <1 ng/mL versus 1–4 ng/mL

“…Due to the specific population of breast cancer patients and their goal of fertility preservation in that study, embryo cryopreservation was a freeze-all condition performed at the pronuclear stage. Several studies have examined whether AMH levels are associated with successful supernumerary embryo cryopreservation, with some data showing a statistically significant correlation (16)(17)(18) and other data showing no difference (25). The cryopreservation of supernumerary embryos in the aforementioned studies was performed on day 3.…”