Can anti-Müllerian hormone be predictive of spontaneous onset of pregnancy in women with unexplained infertility?

Abstract

The objective of the study was to assess anti-Müllerian hormone's (AMH) role in predicting spontaneous onset of pregnancy. This observational cohort study included 83 women with unexplained infertility and normal or low ovarian reserve. Serum AMH, FSH, LH, 17β-oestradiol, inhibin B levels were measured and the number of early antral follicles (2-9 mm) was evaluated on days 2-5 of the cycle. Spearman's correlation was used for comparison of strength of correlation. The diagnostic power of AMH in predicting spontaneous pregnancy was evaluated by receiver operating characteristic (ROC) curves. Markers of ovarian reserve in pregnant women and women without pregnancy were similar. In the entire study population, any markers (AMH, FSH, AFC, age), correlated with each other, but no marker was correlated with pregnancy. The area under the ROC curve for AMH reached a value of 0.385 ± 0.07 (0.25-0.52, 95% confidence interval, CI); for FSH 0.415 ± 0.08 (0.25-0.58, 95% CI); for AFC 0.418 ± 0.08 (0.26-0.57, 95% CI), for age 0.496 ± 0.08 (0.34-0.65, 95% CI). The study did not find a predictive role for AMH in predicting spontaneous onset of pregnancy. Even when AMH levels are very low, a spontaneous pregnancy may still occur.

Anti-Müllerian hormone and ovarian aging in mares

“…However, studies in reproductively seasonal species demonstrate that AMH is far from a perfect index of fertility and subject to considerable, unexplained individual variability (Roosa et al 2015). Similar observations of poor correlations between AMH and the chances of establishing pregnancy have been reported among both fertile women (Streuli et al 2014) and those seeking fertility services (Casadei et al 2013).…”

IVF results in patients with very low serum AMH are significantly affected by chronological age

“…Furthermore, similar to others [29,32], we could not identify a threshold AMH value below in which no pregnancy is likely to occur and IVF should be discouraged. Although with a significantly lower rate, we obtained clinical and ongoing pregnancies even in older patients with very low AMH levels.…”

Antimüllerian hormone levels and antral follicle counts are not reduced compared with community controls in patients with rigorously defined unexplained infertility

“…Antim€ ullerian hormone and AFC exhibit less variability and have widespread clinical use today. Although they predict response to ovarian hyperstimulation, they have not been shown to predict pregnancy after treatment or in natural circumstances (1,28,29).…”