Discrepancies between Antimullerian Hormone and Follicle Stimulating Hormone in Assisted Reproduction

Munawar Hussain,Valentine Akande,Uma Gordon,David Cahill

doi:10.1155/2013/383278

Abstract

Data from 107 women undergoing their first IVF/ICSI were analyzed. Relationships between antimullerian hormone (AMH) and follicle stimulating hormone (FSH) were analyzed after dividing patients into four groups according to AMH/FSH levels. Concordance was noted in 57% of women (both AMH/FSH either normal or abnormal) while 43%of women had discordant values (AMH/FSH one hormone normal and the other abnormal). Group 1 (AMH and FSH in normal range) and group 2 (normal AMH and high FSH) were younger compared to group 3 (low AMH and normal FSH) and group 4 (both AMH/FSH abnormal). Group 1 showing the best oocyte yield was compared to the remaining three groups. Groups 3 and 4 required higher dose of gonadotrophins for controlled ovarian hyperstimulation showing their low ovarian reserve. There was no difference in cycle cancellation, clinical pregnancy, and live birth/ongoing pregnancy rate in all groups. These tests are useful to predict ovarian response but whether AMH is a substantially better predictor is not yet established.

Highlights

Correct assessment of ovarian reserve and prediction of ovarian response to gonadotrophin stimulation are important for patients undergoing assisted reproduction treatment (ART) and are a core issue in modern fertility management [1]
This cohort study was conducted at Bristol Centre for Reproductive Medicine (BCRM) from September 2010 to May 2012
Women undergoing their first IVF/ICSI cycle who had their ovarian reserve assessed by both Gen-2 antimullerian hormone (AMH) assay and follicle stimulating hormone (FSH) were included

Summary

Introduction

Correct assessment of ovarian reserve and prediction of ovarian response to gonadotrophin stimulation are important for patients undergoing assisted reproduction treatment (ART) and are a core issue in modern fertility management [1]. Even the best available ovarian reserve test is associated with 10–20% false positive results [3]. Basal follicle stimulating hormone (FSH) is still the most commonly used ovarian reserve test though its reliability as an ovarian reserve test is weak [4]. Elevated day-3 FSH level is associated with poor response to gonadotrophin stimulation [5] and significantly lower chances of pregnancy [6]. It can only predict ovarian response and chances of pregnancy only at high threshold of values [1, 4, 7]. Using FSH leads to the inconvenience of menstrual cycle day 2–5 testing and is associated with significant inter- and intracycle variability [8]

Methods

Results

Conclusion