Patients with discordant AMH and FSH have a better prognosis in in vitro fertilization than those with two abnormal markers of ovarian reserve

Abstract

ObjectiveTo analyze IVF success and cancellation in a cohort of patients with concordant normal, discordant and concordant abnormal serum Anti Mullerian Hormone(AMH) and basal Follicle Stimulating Hormone(FSH).DesignRetrospective CohortMaterials and MethodsAll patients who underwent their first cycle of IVF and had both AMH and FSH drawn in our practice from 2009-2010 were included for analysis. Patients were stratified into normal FSH and AMH (Group 1; n = 141), abnormal FSH (>11.5) with normal AMH (Group 2; n = 21); normal FSH and abnormal AMH (<1.0) (Group 3, n = 79); and abnormal FSH and AMH (Group 4; n = 28).Results269 women were included in this analysis. Clinical Pregnancy rates were significantly higher in patients with normal ovarian reserve markers (Group 1; 47.5%) versus those with low AMH (group 3 – 25.3% and group 4 - 14.3%). Differences between Group 1 and Group 2 (33.3%) were not significant. Rates of cycle cancellation were significantly higher among patients with low AMH regardless of FSH (group 1 - 6.4%; group 2 - 23.8%; group 3 - 48.1% and group 4- 67.9%). Patients in groups 3 (37.3) and 4 (37.3) were significantly older than those in groups 1 (34.0) and 2 (35.2).ConclusionHaving normal AMH and FSH offers the best prognosis for IVF success. Among patients with an elevated FSH, a normal AMH offered a better prognosis with respect to cycle cancellation. Further prospective research into the implications of AMH with respect to ovarian reserve is warranted. ObjectiveTo analyze IVF success and cancellation in a cohort of patients with concordant normal, discordant and concordant abnormal serum Anti Mullerian Hormone(AMH) and basal Follicle Stimulating Hormone(FSH). To analyze IVF success and cancellation in a cohort of patients with concordant normal, discordant and concordant abnormal serum Anti Mullerian Hormone(AMH) and basal Follicle Stimulating Hormone(FSH). DesignRetrospective Cohort Retrospective Cohort Materials and MethodsAll patients who underwent their first cycle of IVF and had both AMH and FSH drawn in our practice from 2009-2010 were included for analysis. Patients were stratified into normal FSH and AMH (Group 1; n = 141), abnormal FSH (>11.5) with normal AMH (Group 2; n = 21); normal FSH and abnormal AMH (<1.0) (Group 3, n = 79); and abnormal FSH and AMH (Group 4; n = 28). All patients who underwent their first cycle of IVF and had both AMH and FSH drawn in our practice from 2009-2010 were included for analysis. Patients were stratified into normal FSH and AMH (Group 1; n = 141), abnormal FSH (>11.5) with normal AMH (Group 2; n = 21); normal FSH and abnormal AMH (<1.0) (Group 3, n = 79); and abnormal FSH and AMH (Group 4; n = 28). Results269 women were included in this analysis. Clinical Pregnancy rates were significantly higher in patients with normal ovarian reserve markers (Group 1; 47.5%) versus those with low AMH (group 3 – 25.3% and group 4 - 14.3%). Differences between Group 1 and Group 2 (33.3%) were not significant. Rates of cycle cancellation were significantly higher among patients with low AMH regardless of FSH (group 1 - 6.4%; group 2 - 23.8%; group 3 - 48.1% and group 4- 67.9%). Patients in groups 3 (37.3) and 4 (37.3) were significantly older than those in groups 1 (34.0) and 2 (35.2). 269 women were included in this analysis. Clinical Pregnancy rates were significantly higher in patients with normal ovarian reserve markers (Group 1; 47.5%) versus those with low AMH (group 3 – 25.3% and group 4 - 14.3%). Differences between Group 1 and Group 2 (33.3%) were not significant. Rates of cycle cancellation were significantly higher among patients with low AMH regardless of FSH (group 1 - 6.4%; group 2 - 23.8%; group 3 - 48.1% and group 4- 67.9%). Patients in groups 3 (37.3) and 4 (37.3) were significantly older than those in groups 1 (34.0) and 2 (35.2). ConclusionHaving normal AMH and FSH offers the best prognosis for IVF success. Among patients with an elevated FSH, a normal AMH offered a better prognosis with respect to cycle cancellation. Further prospective research into the implications of AMH with respect to ovarian reserve is warranted. Having normal AMH and FSH offers the best prognosis for IVF success. Among patients with an elevated FSH, a normal AMH offered a better prognosis with respect to cycle cancellation. Further prospective research into the implications of AMH with respect to ovarian reserve is warranted.