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Abstract
ObjectiveTo investigate the association between baseline serum Anti-Müllerian hormone (AMH) levels and IVF/ICSI outcomes in women with polycystic ovary syndrome (PCOS).DesignRetrospective study.SettingReproductive medicine center in a hospital.Population2436 PCOS patients (Rotterdam criteria) who underwent their first fresh IVF/ICSI cycles were divided into three groups on the basis of the <25th (Group 1, n=611), 25 to 75th (Group 2, n=1216), or >75th (Group 3, n=609) percentile of baseline serum AMH level.Intervention(s)Baseline serum AMH levels measured on the 2-3 days of spontaneous menstrual cycle before IVF/ICSI treatment.Main Outcome Measure(s)Live birth rate (LBR), cumulative live birth rate (CLBR), clinical pregnancy rate (CPR), and normal fertilization rate (FR).Result(s)The LBR, CPR, and FR were significantly increased in Group 1 than Group 2 and Group 3, however, CLBR was similar between the three groups. The LBR were 46.6%, 40.5%, and 39.4% in Group 1, Group 2, and Group 3 respectively. The CPR were 53.0%, 47.0%, and 45.5%, respectively. The FR was highest in Group 1 (61.7%, P<0.05), but there was no uniform reverse trend with the AMH level. CLBR were 68.7%, 70.4%, and 71.3%, respectively. Although women in Group 1 were older (p < 0.05) and had higher body mass index (BMI) (p < 0.05), binomial logistic regression analysis used age, BMI, FSH, and AMH as independent variables indicated that only AMH was significantly associated with LBR and CPR. Nevertheless, binomial logistic regression analysis used age, BMI, FSH, AMH, and the number of retrieved oocytes as independent variables indicated that only the number of retrieved oocytes was significantly correlated with CLBR. After stratifying by age, the negative relationship between baseline AMH level and LBR and CPR remained only in the patients <30 years old.Conclusion(s)Higher baseline AMH level in PCOS women resulted in lower LBR, CPR, and FR but did not influence CLBR.
Highlights
Anti-Müllerian hormone (AMH) is a dimeric glycoprotein belonging to the transforming growth factor b family
With the extensive use of highly efficient embryo cryopreservation technology, cumulative live birth rate (CLBR) encompassing live birth outcomes in the fresh and subsequent frozen embryo transfer (FET) following a single ovarian stimulation cycle is progressively regarded as a significant indicator for assessing the success of assisted reproductive technology (ART) but so far, no study has directly explored the relationship of CLBR and baseline AMH level in Polycystic ovary syndrome (PCOS) patients
Consistent with the entire population, CLBR was comparable in three groups in all age subgroups. This is the first study to reveal a negative correlation between AMH and fresh clinical pregnancy rate (CPR) and fertilization rate (FR) in PCOS patients
Summary
Anti-Müllerian hormone (AMH) is a dimeric glycoprotein belonging to the transforming growth factor b family. Polycystic ovary syndrome (PCOS) is the most common endocrine disorder, affecting 10 to 20% of reproductive-aged women worldwide [7, 8]. It is the main cause of infertility resulting from hyperandrogenism and oligo-anovulation [7]. With the extensive use of highly efficient embryo cryopreservation technology, cumulative live birth rate (CLBR) encompassing live birth outcomes in the fresh and subsequent frozen embryo transfer (FET) following a single ovarian stimulation cycle is progressively regarded as a significant indicator for assessing the success of ART but so far, no study has directly explored the relationship of CLBR and baseline AMH level in PCOS patients. The objective of the study was to evaluate the relationship between baseline serum AMH levels and reproductive outcomes in a larger PCOS population undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI), especially to discuss the direct relationship of CLBR and baseline AMH levels
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