Anti-mullerian hormone (AMH) and IVF outcomes

Abstract

The primary objective of this study was to evaluate AMH levels as a marker for ovarian reserve and correlate results with IVF outcomes using the Beckman-Coulter diagnostic systems laboratories (DSL) ELISA assay. We retrospectively evaluated 32 IVF cycles for AMH levels and compared this data with previously obtained IVF stimulation records and laboratory values. 192 patient charts were reviewed to identify 32 patients with available serum at our tertiary referral fertility treatment center. A blinded outside laboratory using the Beckman–Coulter DSL immunoassay for AMH levels evaluated stored samples of baseline, stimulation day 3, and ovulation trigger day frozen serum. Comparisons between proportions were performed using the X2–test and contingency table analysis. Means were compared using the Mann–Whitney U test. Correlations were estimated using linear regression analysis and described with Pearson's correlation coefficient®. A P-value < 0.05 was considered statistically significant. Correlation analyses between stimulation AMH and FSH levels are shown in table 1. Cycle stimulation and patient demographic data are detailed in table 2. Baseline FSH, age, and BMI levels were not statistically different between low responders (1st quartile) and high responders (4th quartile).Table 1Correlation of AMH (ng/cc) and FSH (IU/L) Levels with Cycle ResultsDay 3 Baseline FSHDay 3 Baseline AMHStimulation Cycle Day 3 AMHOvulation Trigger Day AMHrPrPrPrPPre-Ovulatory Follicles−0.320.070.530.0020.510.0030.580.0005Oocytes Retrieved−0.470.0090.470.0080.520.0030.440.014 Open table in a new tab Table 2Demographic and Hormonal Cycle Data as a Function of AMH QuartilesA (<25th%ile, n=7)B (25–50th%ile, n=8)C (50–75th%ile, n=8)D (>75th%ile n=9)P-value A vs. DAMH Range (ng/cc)0.0820.83−1.151.16−2.062.07−6.52Baseline AMH (ng/cc)0.54 (±0.22)0.99 (±0.11)1.72 (±0.36)4.32 (±1.55)<0.001Baseline FSH (IU/L)8.53 (±2.85)8.96 (±3.45)6.73 (±1.44)6.67 (±2.72)NSBMI (m/kg2)28.93 (±8.66)23.87 (±4.53)23.64 (±2.51)31.01 (±9.80)NSAge (Years)35.71 (±6.52)36.13 (±5.14)34.44 (±4.48)30.57 (±4.39)NSPeak Estradiol Level (Pg/mL)1481 (±826)2517 (±1491)3425 (±2334)4678 (±2699)<0.05Number of Preovulatory Follicles (>11 mm)7.1 (±2.04)9.75 (±4.03)11.33 (±4.27)13.57 (±2.07)<0.05Number of Oocytes Retrieved4.14 (±2.9)10.86 (±5.64)12.63 (±3.16)14.86 (±5.49)<0.05Implantation Ongoing Gestation (>20 Weeks)2/62/72/72/6NS2/61/72/71/6NS Open table in a new tab DSL Cycle Day 3 AMH levels correlated with oocytes retrieved and pre-ovulatory follicles better than baseline day 3 follicle stimulating hormone, baseline day 3 AMH, and ovulation trigger day AMH levels. High responders had greater peak estradiol levels, more pre-ovulatory follicles and oocytes retrieved. The DSL ELISA assay correlated as well as or better than baseline day 3 FSH levels with the IVF outcomes analyzed.