P-688 The relationship between higher levels of serum AMH and in vitro fertilization outcomes

Abstract

Abstract Study question What is the relationship between increased serum anti-mullerian hormone (AMH) levels and in vitro fertilization (IVF) outcomes in women with infertility? Summary answer High levels of AMH are associated with higher oocytes and embryo number, but a lower proportion of GQE from the transferred and the total number. What is known already Although serum AMH level is considered a predictor of ovarian response to controlled ovarian stimulation, the predictive value of higher AMH levels is not clearly established due to contradictory reports, with both positive and negative associations with IVF outcomes. Study design, size, duration We performed a retrospective study in the Department of Reproductive Medicine of a private hospital. The medical records of all consecutive patients who underwent IVF between January 2014 and December 2021 with all causes of infertility were reviewed. The study group included 1401 patients with a median age [interquartile range] of 35 [6] years and median AMH of 1.99 [2.79] ng/mL. Participants/materials, setting, methods Patients with various causes of infertility undergoing IVF-ICSI and normal ovarian reserve (defined as a serum level of AMH above 1.1 ng/mL) were included in the study. Only patients with serum levels of AMH and age available for analysis were included in the study. The outcomes included were oocytes and obtained embryos number, the proportion of good-quality embryos from the total number of embryos obtained (GQE/T) and from the transferred number of embryos (GQE/Tr). Main results and the role of chance Patients were divided according to their serum AMH level into 3 groups: group 1 with AMH between 1.1 ng/ml and 5 ng/mL, group 2 with AMH between 5 and 8 ng/mL and group 3 with AMH more than 8 ng/mL. After adjustment for age, patients in groups 2 and 3 had a higher number of oocytes (beta 0.231, p < 0.0001 and beta 0.206, p < 0.0001) and embryos (beta 0.143, p < 0.0001 and beta 0.158, p < 0.0001). After adjustment for age, patients in group 2 had a lower proportion of GQE/T in comparison with patients in group 1 (beta -0.077, p 0.037) and patients in both groups 2 (beta -0.119, p 0.001) and 3 (beta -0.103, p 0.004) had a lower proportion of GQE/Tr in comparison with group 1. Being in groups with higher AMH (2 and 3) was not associated with the number of GQE. Limitations, reasons for caution Patients included in this study are infertile patients with an indication for IVF treatment. Therefore, the results of this study should be used with caution in other populations Wider implications of the findings Our study suggests that having higher levels of serum AMH (above 5 ng/mL) is not associated with better IVF outcomes in terms of the number of good-quality embryos. Moreover, obtaining a higher number of embryos is not associated with a proportional increase in good-quality embryo availability. Trial registration number NA