Value of antimüllerian hormone as a prognostic indicator of in vitro fertilization outcome

Reichman, Daniël; Goldschlag, Dan; Rosenwaks, Zev

doi:10.1016/j.fertnstert.2013.12.039

Cited by 86 publications

(70 citation statements)

References 34 publications

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“…OR of 0.3 can be interpreted as a 70 % reduction in low oocyte yield for each additional unit increase of AMH. This is consistent with prior studies in healthy populations demonstrating the predictive power of AMH for response to stimulation and ART outcomes [32,33]. Low AMH has been associated with poor response to stimulation and oocyte yield [34][35][36] and may also be useful information prior to starting the cycle.…”

Section: Discussionsupporting

confidence: 90%

Outcomes of ovarian stimulation after treatment with chemotherapy

Chan

Johnson

Efymow

et al. 2015

J Assist Reprod Genet

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Purpose Chemotherapeutic agents have a known gonadotoxic effect; however, it is difficult to predict the impact they may have on ovarian stimulation. The objective of this study was to evaluate response to ovarian stimulation in patients exposed to chemotherapy compared with patients who were chemotherapy-naïve. Methods A retrospective cohort study of 130 patients with cancer or autoimmune disease was performed. Demographics, ovarian reserve, ovarian response and stimulation parameters, and oocyte data were compared between patients who were pre-and post-chemotherapy. Logistic regression modeling was performed to identify risk factors for cancellation and low oocyte yield, adjusting for confounders as appropriate. Results Antral follicle count (AFC) was significantly lower in post-chemo patients (9 vs. 17, p<0.001). Post-chemotherapy patients were more likely to be cancelled during stimulation (23 vs. 4 %, p=0.003). Among those that went to retrieval, there was no difference in total number of oocytes (10 vs. 10, p=0.31) or mature oocytes retrieved (8 vs. 8, p=0.38), despite higher starting (300 vs. 450 IU, p<0.001) and total gonadotropin (3075 vs. 4612.5 IU, p=0.008) doses in post-chemotherapy patients. Low AFC (≤6) was associated with cycle cancellation (OR 7.7, 95 % CI 1.8-33.2) and low oocyte yield (<6) (OR 5.4, 95 % CI 1.6-17.7). Conclusions Patients post-chemotherapy have lower AFC compared with the chemotherapy-naïve and have higher cancellation rates. Among those who underwent oocyte retrieval, oocyte yield was similar in both groups. Low AFC was most strongly associated with cycle cancellation and oocyte yield. Post-chemotherapy patients had higher rates of cycle cancellation but did equally well as pre-chemotherapy patients if they reached retrieval.

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Section: Discussionsupporting

confidence: 90%

Outcomes of ovarian stimulation after treatment with chemotherapy

Chan

Johnson

Efymow

et al. 2015

J Assist Reprod Genet

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“…Clinical and laboratory protocols COH, hCG trigger, oocyte retrieval, embryo culture, and ET were carried out per our standard protocols [14][15][16]. Some patients were down regulated using a GnRH agonist (Lupron; Abbott Pharmaceuticals) followed by stimulation with gonadotropins ( , according to a dosing scheme ranging from 10,000 to 3,300 IU based on serum E 2 levels [14][15][16].…”

Section: Cycle Inclusion Criteriamentioning

confidence: 99%

“…Some patients were down regulated using a GnRH agonist (Lupron; Abbott Pharmaceuticals) followed by stimulation with gonadotropins ( , according to a dosing scheme ranging from 10,000 to 3,300 IU based on serum E 2 levels [14][15][16]. In general, the hCG trigger was administered when the two lead follicles attained a mean diameter ≥17 mm.…”

Section: Cycle Inclusion Criteriamentioning

confidence: 99%

Impact of elevated peak serum estradiol levels during controlled ovarian hyperstimulation on the birth weight of term singletons from fresh IVF-ET cycles

Pereira

Reichman

Goldschlag

et al. 2015

J Assist Reprod Genet

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Purpose To investigate the impact of elevated serum estradiol (E 2 ) levels on the day of hCG trigger on the birth weight of term singletons after fresh In Vitro Fertilization (IVF)-Embryo Transfer (ET) cycles. Methods Retrospective cohort study of all patients initiating fresh IVF-ET cycles resulting in live births between January 2004 and February 2013. The incidence of low birthweight (LBW) term singletons in patients with E 2 levels on day of hCG trigger above or below the 95 % cutoff for E 2 values in our clinic (3,069.2 pg/mL) was estimated. Multiple gestations and vanishing twin pregnancies were excluded. Results Two thousand nine hundred thirty-nine singleton live births were identified for inclusion. One hundred forty seven (5 %) and 2792 (95 %) live singleton births occurred in patients with peak E 2 levels above and below 3,069.2 pg/mL, respectively. The overall incidence of term LBW was 5.4 % in the >3,069.2 pg/mL group compared to 2.4 % in the ≤3,069.2 pg/mL group (P=.038). An E 2 level >3,069.2 pg/mL on the day of hCG administration was associated with increased odds of LBW term singletons (OR=2.29; 95 % CI=1.03-5.11). The increased odds remained unchanged when adjusting for maternal age (aOR=2.29; 95 % CI=1.02-5.14; P=.037), gestational age at delivery (aOR=2.04; 95 % CI=1.22-3.98; P=.025), and day 3 versus blastocyst transfer (aOR=2.5; 95 % CI=1.11-5.64; P=.023).Conclusions Peak E 2 level >3,069.2 pg/mL is associated with increased odds of LBW term singletons after fresh IVF-ET cycles. Conservative stimulation protocols aiming not to exceed an E 2 level of 3,000 pg/mL may be advantageous for placentation and fetal growth if a fresh transfer is planned.

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“…Low levels of anti-Müllerian hormone and AFC are weak prognostic markers for stimulation in in vitro fertilization (IVF), and they are considered to be equivalent parameters for prediction of treatment success. The risk of IVF cycle cancellation could be 13 times higher in patients with undetectable AMH levels than in those with an AMH level higher than 2.0 ng/mL [22]. Decreased AMH concentrations do not exclude the possibility of getting pregnant, although the success rate is much lower.…”

Section: The Use Of Amh In Assisted Reproduction Techniquesmentioning

confidence: 98%

“…However, analysis presented by Łukaszuk et al [24] examined 101 women with AMH levels < 0.4 ng/mL during 188 in vitro cycles and achieved 14 live births, making the IVF procedure 7.45% effective. Thus, low concentrations of AMH require different stimulation protocols, in particular, short and ultrashort protocols with high initial dosages of gonadotropins [22].…”

Section: The Use Of Amh In Assisted Reproduction Techniquesmentioning

confidence: 99%

Anti-Müllerian hormone: a critical factor for female fertility and reproductive health

Rzeszowska

Leszcz²,

Putowski³

et al. 2016

Ginekol Pol

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Anti-Müllerian hormone (AMH) is a glycoprotein produced by the granulosa cells of preantral and small antral follicles. AMH concentrations reflect ovarian physiology with high precision, thus serving as a more sensitive marker of the ovarian reserve than chronological age. This hormone plays a role in the pathogenesis of menstrual disorders and fertility in both obesity and polycystic ovary syndrome. The evaluation of AMH may also be useful in diagnosing or monitoring therapy of granulosa cell ovarian tumors.

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Value of antimüllerian hormone as a prognostic indicator of in vitro fertilization outcome

Cited by 86 publications

References 34 publications

Outcomes of ovarian stimulation after treatment with chemotherapy

Outcomes of ovarian stimulation after treatment with chemotherapy

Impact of elevated peak serum estradiol levels during controlled ovarian hyperstimulation on the birth weight of term singletons from fresh IVF-ET cycles

Anti-Müllerian hormone: a critical factor for female fertility and reproductive health

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