The value of Anti-Müllerian hormone in low and extremely low ovarian reserve in relation to live birth after in vitro fertilization

Reijnders, Igna F.; Nelen, W.L.D.M.; IntHout, Joanna; Herwaarden, Antonius E. van; Braat, D.D.M.; Fleischer, Kathrin

doi:10.1016/j.ejogrb.2016.02.007

Cited by 20 publications

(18 citation statements)

References 23 publications

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“…Also, the level of AMH is associated with LBR after IVF/ICSI in women with (extremely) low ovarian reserve. The LBR in women with AMH ≥0.4ng/ml was significantly higher than in women with AMH ≤0.4ng/ml ( Reijnders et al , 2016 ). AMH could serve as a tool in the pre-treatment counseling for pregnancy likelihood in women with (extremely) low ovarian reserve.…”

Section: Discussionmentioning

confidence: 85%

Key performance indicators score (KPIs-score) based on clinical and laboratorial parameters can establish benchmarks for internal quality control in an ART program

Franco

Petersen

Mauri

et al. 2017

JBRA Assisted Reproduction

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ObjectiveKPIs have been employed for internal quality control (IQC) in ART. However, clinical KPIs (C-KPIs) such as age, AMH and number of oocytes collected are never added to laboratory KPIs (L-KPIs), such as fertilization rate and morphological quality of the embryos for analysis, even though the final endpoint is the evaluation of clinical pregnancy rates. This paper analyzed if a KPIs-score strategy with clinical and laboratorial parameters could be used to establish benchmarks for IQC in ART cycles.MethodsIn this prospective cohort study, 280 patients (36.4±4.3years) underwent ART. The total KPIs-score was obtained by the analysis of age, AMH (AMH Gen II ELISA/pre-mixing modified, Beckman Coulter Inc.), number of metaphase-II oocytes, fertilization rates and morphological quality of the embryonic lot.ResultsThe total KPIs-score (C-KPIs+L-KPIs) was correlated with the presence or absence of clinical pregnancy. The relationship between the C-KPIs and L-KPIs scores was analyzed to establish quality standards, to increase the performance of clinical and laboratorial processes in ART. The logistic regression model (LRM), with respect to pregnancy and total KPIs-score (280 patients/102 clinical pregnancies), yielded an odds ratio of 1.24 (95%CI = 1.16-1.32). There was also a significant difference (p<0.0001) with respect to the total KPIs-score mean value between the group of patients with clinical pregnancies (total KPIs-score=20.4±3.7) and the group without clinical pregnancies (total KPIs-score=15.9±5). Clinical pregnancy probabilities (CPP) can be obtained using the LRM (prediction key) with the total KPIs-score as a predictor variable. The mean C-KPIs and L-KPIs scores obtained in the pregnancy group were 11.9±2.9 and 8.5±1.7, respectively. Routinely, in all cases where the C-KPIs score was ≥9, after the procedure, the L-KPIs score obtained was ≤6, a revision of the laboratory procedure was performed to assess quality standards.ConclusionThis total KPIs-score could set up benchmarks for clinical pregnancy. Moreover, IQC can use C-KPIs and L-KPIs scores to detect problems in the clinical-laboratorial interface.

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Section: Discussionmentioning

confidence: 85%

Key performance indicators score (KPIs-score) based on clinical and laboratorial parameters can establish benchmarks for internal quality control in an ART program

Franco

Petersen

Mauri

et al. 2017

JBRA Assisted Reproduction

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“…Diminished ovarian reserve (DOR), a specific ovarian status with a reduced number of primordial follicles, remains a clinical concern in the field of assisted reproductive technology (ART). For patients with DOR, live birth rates (LBRs) per cycle vary from less than 10% to nearly 30% . Currently, over 10 different definitions of DOR have been documented, with antral follicle count (AFC), anti‐Müllerian hormone (AMH) serum levels, or basal follicle stimulating hormone (FSH) serum levels as the determining criteria.…”

Section: Introductionmentioning

confidence: 99%

Predictors of live birth rate in women with diminished ovarian reserve

Huang

Wang

et al. 2020

Intl J Gynecology & Obste

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Objective To investigate the chance of live birth after several oocyte retrieval cycles in patients with diminished ovarian reserve (DOR) and identify the possible predictors. Methods A retrospective analysis of 931 patients with DOR who underwent in vitro fertilization at a university hospital in China between January 2012 and December 2014. All data for fresh and the associated frozen‐thawed embryo transfer attempts were analyzed. Conditional and cumulative live birth rates (LBRs) were calculated. Mediation and logistic regression analyses were performed to determine the predictors of live birth. Results Conditional LBRs remained around 10.0% in the first five cycles. Conservative cumulative LBRs (CLBRs) reached 22.0% after three cycles and increased to 24.8% after six cycles; optimal CLBRs increased from 12.9% to nearly 50.0% after six cycles. Patient age and the number of good‐quality embryos were two key predictors in determining the conditional and conservative LBRs. Conclusion For patients with DOR, conditional LBR remained constant in the first five cycles, and patients should be encouraged to continue to three or five completed cycles to maximize their chance of live birth. Patient age and the number of good‐quality embryos were two key factors to predict live birth.

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“…Since serum AMH levels are not affected by hormonal status(19)(20), clinicians may measure AMH serum levels during hormonal therapy, or several days before the withdrawal periods, in order to predict follicle growth.Thirdly, the results of this study are limited to the prediction of follicle growth, and all seven patients who exhibited follicle growth in this study have failed to achieve pregnancy. Previous reports indicated that the median serum AMH level of patients with successful IVF was 837 (range: 141.6-2750) pg/mL(21), and live birth rate was significantly lower in women with AMH ≤ 0.1 ng/mL(22).Consequently, it cannot be declared that detection of AMH by the picoAMH kit in POI patients raises the probability of successful IVF or pregnancy. Fourthly, donor oocytes are available for patients with POI in some countries.…”

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confidence: 97%

Very low levels of serum anti- Müllerian hormone as a possible marker for follicle growth in patients with primary ovarian insufficiency under hormone replacement therapy

Kasahara

Osuka

Bayasula

et al. 2020

Preprint

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Background Patients with primary ovarian insufficiency (POI) occasionally present with follicle growth; however, it is difficult to predict exactly which cycles will show follicle growth. Serum anti-Müllerian hormone (AMH), a useful marker for ovarian reserve, is produced in early-stage follicles. Therefore, AMH levels should reflect the presence of small follicles, which are difficult to detect using ultrasonography, and may be useful as a marker for predicting follicle growth in patients with POI. Methods Using an ultrasensitive enzyme-linked immunosorbent assay (ELISA) kit, we found very low serum AMH levels in patients with POI. We assessed the follicle growth of each patient during each cycle to clarify the usefulness of measuring serum AMH levels for predicting follicle growth in patients with POI under hormone replacement therapy (HRT). Results A total of 91 cycles of 19 patients with POI were analyzed in this study. Five patients presented with positive serum AMH levels during the observational periods, and all five experienced follicle growth. Only two of the 14 patients with negative serum AMH levels had follicle growth. Serum AMH and follicle-stimulating hormone (FSH) levels in cycles with follicle growth were significantly higher than in cycles without follicle growth. The median serum AMH level (2.77 pg/mL; 25 th , 75 th percentiles: 0.0, 9.64) in cycles with follicle growth was lower than the lower limit of detection of conventional AMH ELISA kits. The positive predictive value of positive serum AMH levels for follicle growth was higher than that of FSH (< 10 mIU/mL). Conclusions Measurement of very low levels of serum AMH using picoAMH assays is useful for prediction of follicle growth in patients with POI under HRT conditions.

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The value of Anti-Müllerian hormone in low and extremely low ovarian reserve in relation to live birth after in vitro fertilization

Cited by 20 publications

References 23 publications

Key performance indicators score (KPIs-score) based on clinical and laboratorial parameters can establish benchmarks for internal quality control in an ART program

Key performance indicators score (KPIs-score) based on clinical and laboratorial parameters can establish benchmarks for internal quality control in an ART program

Predictors of live birth rate in women with diminished ovarian reserve

Very low levels of serum anti- Müllerian hormone as a possible marker for follicle growth in patients with primary ovarian insufficiency under hormone replacement therapy

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