Comparing serum basal and follicular fluid levels of anti-Müllerian hormone as a predictor of in vitro fertilization outcomes in patients with and without polycystic ovary syndrome

Abstract

BACKGROUND AND OBJECTIVES:The prediction of in vitro fertilization (IVF) outcomes by anti-Müllerian hormone (AMH) measurement is getting increasing attention from clinicians. This study compares the relationship between serum or intrafollicular AMH levels and IVF outcomes in women with and without polycystic ovary syndrome (PCOS).METHODS:This prospective study was carried out in two university-based fertility clinics. Serum samples were collected on cycle day 3 and follicular fluid (FF) was collected on the day of oocyte retrieval from 26 women with PCOS and 42 normo-ovulatory controls. AMH levels were measured in the samples using immunoenzymatic assay. The relationship between serum or FF AMH levels and IVF outcomes, including number of oocytes retrieved, oocyte maturation rate, fertilization rate, implantation rate, high quality grade embryo rate, and biochemical and clinical pregnancy rates were further assessed.RESULTS:Median serum basal AMH and FF AMH levels were significantly higher in the PCOS group as compared to controls, the values being 14.2 ng/mL vs. 3.2 ng/mL (P<.001) and 8.2 ng/g protein vs. 4.7 ng/g protein (P<.01), respectively. In both groups, serum basal AMH levels showed a positive correlation with number of oocytes retrieved (r=0.323; P=.037 in control vs. r=0.529; P=.005 in PCOS). In the control group, there was a positive relationship between serum basal AMH levels and percentage of matured oocytes (r = 0.331; P=.032) and implantation rate (r=0.305; P=.05).CONCLUSION:Serum basal, and not intrafollicular, AMH levels may be a good predictive factor for quantitative and qualitative IVF outcomes in normo-ovulatory, but not in PCOS patients.

Effect of Anti-Müllerian hormone (AMH) and bone morphogenetic protein 15 (BMP-15) on steroidogenesis in primary-cultured human luteinizing granulosa cells through Smad5 signalling

“…Studies in mice have identified the necessity of AMH in the preservation of the primordial follicle pool by inhibiting the follicular activation and growth as well as the follicle sensitivity to FSH [13,14]. Furthermore, data in the human reveal that serum AMH levels can be used as an ovarian follicular reserve marker [15,16], as well as a predictor of the ovarian responsiveness in normo-ovulatory women undergoing ovarian stimulation for IVF [17][18][19][20]. In addition, the importance of this hormone in the follicular recruitment arises from a number of studies, which correlate serum and follicular fluid AMH levels with the high number of 2-5 mm follicles in PCOS women [21][22][23][24][25], thus giving another clue to the clarification of the polycystic ovary syndrome pathology.…”

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

“…It inhibits the initiation of human primordial follicle growth and prevents multiple selection of a dominant follicle by reducing the sensitivity of follicles to follicle stimulating hormone (FSH) [1]. Several reports suggest that AMH might be a better predictor of ovarian responses to controlled ovarian hyperstimulation (COS) than traditional parameters such as age, FSH, estradiol (E 2 ) and inhibin B (INH-B) [7].…”

Transvaginal ovarian drilling followed by controlled ovarian stimulation from the next day improves ovarian response for the poor responders with polycystic ovary syndrome during IVF treatment: a pilot study

“…Moreover, studies have shown that AMH values can be influenced by comparable technical, physiological and exogenous factors [34]. Previous studies have shown that the range of AMH levels in PCOS patients is various [35][36][37], from 0.64 to 50.7 ng/ml [38]. However, these studies did not evaluate the ovarian response in these PCOS patients, we thus hypothesize that the AMH levels in the normal responders may be lower than those in the high responders.…”