The use of anti mullerian hormone in the evaluation of egg donors

Abstract

OBJECTIVE: Based on our experience with infertile women undergoing gonadotropin stimulation we determined that 1.4ng/mL would be the minimal level for allowing women to donate in order to have confidence that an adequate number of oocytes would be retrieved. This study was performed to evaluate the utility of AMH testing in egg donors.DESIGN: Retrospective cohort study.MATERIALS AND METHODS: 25 donors, ages 19 to 28 had undergone ovarian hyperstimulation followed by egg retrieval. All donors had AMH levels ≥1.4 ng/mL. Stimulation consisted of combined oral contraceptive pills followed by FSH stimulation. GnRH antagonist was added once a lead follicle was 12 mm and recombinant hCG (250 mcg) was given when two lead follicles were >17mm. Number of eggs retrieved, number of mature eggs, and number of IUs of FSH used were recorded. We performed linear regression to determine if AMH predicted the number of oocytes retrieved, the number of mature oocytes, and the amount of FSH used. For donors who had undergone multiple cycles for egg donation, only the first cycle was used in the analysis.RESULTS: The mean AMH value was 3.36ng/mL±1.69(SD). The average amount of FSH used was 2264IU±773. The mean number of total and mature eggs retrieved were 21.1±10.1 and 16.6±8.1, respectively. The total number of eggs ranged from 9-46 and the number of mature eggs ranged from 6-36. AMH did not predict the number of eggs retrieved (B=0.9±1.17,t=0.77,P=0.45), the number of mature eggs (B=0.19±0.97,t=0.2,P=0.84), or the amount of FSH used (B=-150.5±76.38,t=-1.97,P=0.57).CONCLUSIONS: In our egg donors, AMH levels did not predict the amount of gonadotropin needed for stimulation. Furthermore, AMH did not predict the total number of eggs retrieved or the number of mature eggs retrieved. In our experience, an AMH level ≥ 1.4 ng/mL allowed us to confidently tell recipients that a donor would produce an average of 21 eggs, with an average of 16 being mature. We propose that an AMH of 1.4 ng/mL be used to determine suitability of a potential egg donor. OBJECTIVE: Based on our experience with infertile women undergoing gonadotropin stimulation we determined that 1.4ng/mL would be the minimal level for allowing women to donate in order to have confidence that an adequate number of oocytes would be retrieved. This study was performed to evaluate the utility of AMH testing in egg donors. DESIGN: Retrospective cohort study. MATERIALS AND METHODS: 25 donors, ages 19 to 28 had undergone ovarian hyperstimulation followed by egg retrieval. All donors had AMH levels ≥1.4 ng/mL. Stimulation consisted of combined oral contraceptive pills followed by FSH stimulation. GnRH antagonist was added once a lead follicle was 12 mm and recombinant hCG (250 mcg) was given when two lead follicles were >17mm. Number of eggs retrieved, number of mature eggs, and number of IUs of FSH used were recorded. We performed linear regression to determine if AMH predicted the number of oocytes retrieved, the number of mature oocytes, and the amount of FSH used. For donors who had undergone multiple cycles for egg donation, only the first cycle was used in the analysis. RESULTS: The mean AMH value was 3.36ng/mL±1.69(SD). The average amount of FSH used was 2264IU±773. The mean number of total and mature eggs retrieved were 21.1±10.1 and 16.6±8.1, respectively. The total number of eggs ranged from 9-46 and the number of mature eggs ranged from 6-36. AMH did not predict the number of eggs retrieved (B=0.9±1.17,t=0.77,P=0.45), the number of mature eggs (B=0.19±0.97,t=0.2,P=0.84), or the amount of FSH used (B=-150.5±76.38,t=-1.97,P=0.57). CONCLUSIONS: In our egg donors, AMH levels did not predict the amount of gonadotropin needed for stimulation. Furthermore, AMH did not predict the total number of eggs retrieved or the number of mature eggs retrieved. In our experience, an AMH level ≥ 1.4 ng/mL allowed us to confidently tell recipients that a donor would produce an average of 21 eggs, with an average of 16 being mature. We propose that an AMH of 1.4 ng/mL be used to determine suitability of a potential egg donor.