Anti-Müllerian hormone levels to predict oocyte maturity and embryo quality during controlled ovarian hyperstimulation.

Abstract

The aim of this study was to assess the correlation between controlled ovarian hyperstimulation (COH) outcome parameters and anti-Müllerian hormone (AMH) serum levels during in vitro fertilization (IVF) treatment in women with varying ovarian reserve levels. Prospective study of 46 women undergoing GnRH-antagonist short protocol for IVF. Participants included women with low ovarian reserve (N.=11), normoreserve (N.=16), and polycystic ovarian syndrome (PCOS; N.=19). AMH was measured on menstrual cycle day 1-3 (basal AMH), on the day of GnRH-antagonist administration (AMH-GnRH), on the day of hCG administration (AMH-hCG), and in follicular fluid on the day of oocyte retrieval (AMH-FF). Basal AMH was significantly correlated (P<0.001) with antral follicle count and number of follicles >11mm on hCG day (P<0.05). Both basal AMH and AMH-GnRH were significantly correlated (P<0.05) with the number of oocytes retrieved and metaphase II. AMH-hCG was correlated with top quality embryos (P=0.04). No correlations were found between COH outcome parameters and AMH-FF. Basal AMH serum concentration was the strongest predictor of oocyte yield. AMH concentration at the mid-follicular phase was also a good predictor of oocyte yield and this marker was the only useful ovarian reserve indicator during the follicle growth process to predict IVF outcomes. AMH-hCG levels appear to predict embryo quality. AMH levels during the COH can provide valuable data to help individualize treatment and predict COH results.