Clin Exp Reprod Med.  2011 Sep;38(3):153-158. 10.5653/cerm.2011.38.3.153.

Serum anti-Mullerian hormone levels as a predictor of the ovarian response and IVF outcomes

• Choi MH
• Yoo JH
• Kim HO
• Cha SH
• Park CW
• Yang KM
• Song IO
• Koong MK
• Kang IS

• KMID: 1973532
• DOI: http://doi.org/10.5653/cerm.2011.38.3.153

Abstract

OBJECTIVE
The aim of this study was to investigate whether anti-Mullerian hormone (AMH) levels could be predict ovarian poor/hyper response and IVF cycle outcome.
METHODS
Between May 2010 and January 2011, serum AMH levels were evaluated with retrospective analysis. Three hundred seventy infertile women undergoing 461 IVF cycles between the ages of 20 and 42 were studied. We defined the poor response as the number of oocytes retrieved was equal or less than 3, and the hyper response as more than 25 oocytes retrieved. Serum AMH was measured by commercial enzyme-linked immunoassay.
RESULTS
The number of oocytes retrieved was more correlated with the serum AMH level (r=0.781, p<0.01) than serum FSH (r=-0.412, p<0.01). The cut-off value of serum AMH levels for poor response was 1.05 ng/mL (receiver operating characteristic [ROC] curves/area under the curve [AUC], ROC(AUC)=0.85, sensitivity 74%, specificity 87%). Hyper response cut-off value was 3.55 ng/mL (ROC(AUC)=0.91, sensitivity 94%, specificity 81%). When the study group was divided according to the serum AMH levels (low: <1.05 ng/mL, middle: 1.05 ng/mL - 3.55 ng/mL, high: >3.55 ng/mL), the groups showed no statistical differences in mature oocyte rates (71.6% vs. 76.5% vs. 74.8%) or fertilization rates (76.9% vs. 76.6% vs. 73.8%), but showed significant differences in clinical pregnancy rates (21.7% vs. 24.1% vs. 40.8%, p=0.017).
CONCLUSION
The serum AMH level can be used to predict the number of oocytes retrieved in patients, distinguishing poor and high responders.

Keyword

Anti-Mullerian Hormone; Ovarian Response; Poor Response; Hyper Reponse; In Vitro Fertilization; Human

MeSH Terms

Anti-Mullerian Hormone
Female
Fertilization
Fertilization in Vitro
Humans
Oocytes
Pregnancy Rate
Retrospective Studies
Sensitivity and Specificity
Anti-Mullerian Hormone