IVF outcome with a high level of AMH: a focus on PCOS versus non-PCOS

Natadisastra, Muharam; Prasetyo, Yohanes Danang; Prabowo, Kevin Ardito; Putri, Yuannita Ika; Maidarti, Mila; Hestiantoro, Andon

doi:10.1186/s12905-022-01756-4

Cited by 8 publications

(4 citation statements)

References 25 publications

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“…However, our results are in line with a recent meta-analysis which concluded that "there is probably little or no difference in cumulative live birth rate between the 'freeze all' strategy and the conventional IVF/ICSI strategy" [49]. The main widely recognized advantage for the 'freeze all' strategy is the prevention of OHSS, which is more frequent in women with PCOS and 'high' AMH levels [50]. Nevertheless, our data cannot support that hypothesis nor strategy.…”

Section: Discussionsupporting

confidence: 89%

Elevated Anti-Müllerian Hormone as a Prognostic Factor for Poor Outcomes of In Vitro Fertilization in Women with Polycystic Ovary Syndrome

Vale-Fernandes,

Barreiro,

Leal

et al. 2023

Biomedicines

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Women with polycystic ovary syndrome (PCOS) tend to have elevated anti-Müllerian hormone (AMH) levels, which appear to correlate with disease severity and pregnancy outcomes. This was a retrospective observational study designed to assess the relationship between circulating AMH levels and in vitro fertilization (IVF) outcomes. The study involved 150 women with PCOS who underwent IVF treatments. The women’s IVF cycles were allocated into three subgroups according to AMH levels: ‘low’ (AMH < 3.7 ng/mL; n = 49), ‘middle’ (AMH 3.7–7.4 ng/mL; n = 94), and ‘high’ (AMH > 7.4 ng/mL; n = 56). All pregnancy-related outcomes (positive beta human chorionic gonadotropin (βHCG), clinical pregnancy rate, live birth rate, and cumulative live birth rate) were greater in women’s IVF cycles with ‘low’ AMH when compared to those with ‘middle’ or ‘high’ AMH (p < 0.05). AMH levels below 3.7 ng/mL were found to be associated with lower oocyte immaturity rate and better pregnancy outcomes, although baseline AMH was not shown to have any significant predictive power for live birth and cumulative live birth in the multivariable logistic regression analysis after adjusting for possible confounders nor in the ROC analyses. In summary, the current study lays the groundwork to validate high AMH levels as a poor prognostic factor for pregnancy outcomes after IVF in women with PCOS.

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Section: Discussionsupporting

confidence: 89%

Elevated Anti-Müllerian Hormone as a Prognostic Factor for Poor Outcomes of In Vitro Fertilization in Women with Polycystic Ovary Syndrome

Vale-Fernandes,

Barreiro,

Leal

et al. 2023

Biomedicines

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“…When Kamel et al [ 33 ] divided patients into two groups (AMH cutoff value: 4.6 ng/ml) and used GnRH antagonist, they found that the incidence of severe OHSS was significantly higher in patients with AMH > 4.6 ng/ml ( p = 0.026). In addition, Muharam et al [ 30 ] tried to determine the cutoff value of AMH to predict hyperresponse in PCOS patients undergoing controlled ovarian stimulation. The AUC of the ROC curve was 0.626 (95% CI; sensitivity: 71.8%; specificity: 52.7%), indicating poor predictive quality.…”

Section: Resultsmentioning

confidence: 99%

Association between serum AMH levels and IVF/ICSI outcomes in patients with polycystic ovary syndrome: a systematic review and meta-analysis

Yuwen,

Yang,

Cai

et al. 2023

Reprod Biol Endocrinol

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Context Anti-Müllerian hormone (AMH) levels are increased in polycystic ovary syndrome (PCOS) patients and are associated with PCOS severity. Objective To evaluate the associations between serum AMH levels and in vitro fertilization (IVF)/ intracytoplasmic sperm injection (ICSI) outcomes in patients with PCOS. Data sources PubMed, Embase, and the Cochrane Library were searched on 11 July 2022. Study selection Studies reporting the association between serum AMH levels and IVF/ICSI outcomes in PCOS patients were considered for inclusion. The primary outcomes were clinical pregnancy, live birth, and ovarian hyperstimulation syndrome. Data extraction Data were extracted using a standardized data extraction form. Study quality was assessed independently by two groups of researchers. Data synthesis Nineteen studies were included in this review. Meta-analyses demonstrated that PCOS patients with a serum AMH level within the 75-100th percentile had a decreased odds of clinical pregnancy (OR: 0.77, 95% CI: 0.63–0.93) and livebirth (OR: 0.71; 95% CI: 0.58–0.87) compared to those within the 0-25th percentile. An increased AMH level was also correlated with an increased number of oocytes retrieved (SMD: 0.90, 95% CI: 0.30–1.51) and a lower odds of fertilization (OR: 0.92, 95% CI: 0.87–0.98). There was no significant difference in the number of MII oocytes (SMD: 1.85, 95% CI: -1.07–4.78), E2 on the day of hCG (SMD: 0.12; 95% CI: -0.98–1.23), or implantation (OR: 0.82, 95% CI: 0.28–2.39) between the two groups. In addition, we found significant dose–response associations between serum AMH level and clinical pregnancy, live birth, number of oocytes retrieved, and fertilization in PCOS patients. Conclusion AMH may have clinical utility in counseling regarding IVF/ICSI outcomes among women with PCOS who wish to undergo fertility treatment. More large-scale, high-quality cohort studies are needed to confirm these findings.

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“…That was in line with other studies where PCOS cases were expected to be a hyper-responder and to have higher No. of the retrieved oocyte with a comparable pregnancy rate and good-quality embryo [32].…”

Section: Tabatabaie Et Al Study Confirmed the Presence Of Star Gene I...mentioning

confidence: 94%

The effect of adipose tissue StAR gene expression on ICSI among Polycystic Ovarian Syndrome cases and matched controls: a case-control study

Helmi¹,

Nori²

2024

Ital J Gynaecol Obstet

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Objective. steroidogenesis is vital for reproduction and fertility; it is governed by the acute regulatory protein gene (StAR). Earlier work discussed a different StAR expression in the adipose tissue (AT) of pregnant polycystic ovarian syndrome (PCOS) women. This study examined the correlation of StAR expression levels in AT of PCOS women to various parameters of intracytoplasmic sperm injection (ICSI) compared to those without. Patients and methods.A case-control study recruited 40 infertile women who had successful ICSI cycles into 2 groups: 20/40 cases and 20/40 non-PCOS cases; both groups were age and body mass index-matched for scheduled elective cesarean section. A sample of anterior abdominal wall AT was taken for a real-time PCR StAR gene expression. ICSI parameters, including hormonal, ultrasonic, stimulation drug doses and duration, and the outcome, were all retrospectively recorded and correlated with StAR gene expression.Results. StAR gene folding was higher among PCOS-pregnant women (2.545 ±1.58 vs. 1.00 ±0.0), P-value< 0.023. estradiol hormone was correlated to StAR gene; -0.39, P<0.05. The total doses of recombinant follicle-stimulating hormone and human menopausal gonadotropin had significant correlations to StAR gene r= (-0.39, 0.60), P-value of (0.049, 0.005), respectively.Conclusions. The significant association of StAR gene expression with stimulation drug doses suggests a clinical application, as it can reduce ovarian hyperstimulation syndrome and overall expense, which makes ICSI safer and more accessible to infertile couples. Women with PCOS present challenges in ICSI, and thus careful balance must be adjusted.

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IVF outcome with a high level of AMH: a focus on PCOS versus non-PCOS

Cited by 8 publications

References 25 publications

Elevated Anti-Müllerian Hormone as a Prognostic Factor for Poor Outcomes of In Vitro Fertilization in Women with Polycystic Ovary Syndrome

Elevated Anti-Müllerian Hormone as a Prognostic Factor for Poor Outcomes of In Vitro Fertilization in Women with Polycystic Ovary Syndrome

Association between serum AMH levels and IVF/ICSI outcomes in patients with polycystic ovary syndrome: a systematic review and meta-analysis

The effect of adipose tissue StAR gene expression on ICSI among Polycystic Ovarian Syndrome cases and matched controls: a case-control study

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