PURPOSE: Although studies of serum anti-Müllerian hormone (AMH) in predicting ovarian reserve are numerous, many studies utilized patients under age 40. However, the assessment of ovarian reserve is especially critical in older infertile women. This study evaluates the significance of AMH level in patients over age 40 at the time of their first in vitro fertilization (IVF) treatment. METHODS: Forty-nine women over age 40 were studied. Although serum samples were taken prior to their IVF treatments, the data of serum AMH of patients were not taken into consideration to determine the therapy strategy, including follicle induction in which clomiphene citrate and human menopausal gonadotropin were used. RESULT(S): Twelve out of 49 patients achieved a clinical pregnancy (24.4 %). There was a positive correlation between serum AMH levels and the number of oocytes retrieved (P < 0.0001). The ROC curve analysis for prediction of poor ovarian response, ≤3 retrieved oocytes, showed that the optimum cut-off level was < 1.0 ng/mL for AMH. The lower AMH group (AMH < 1.0 ng/ml) showed less chance of undergoing embryo transfer than the higher AMH group (AMH ≥1.0 ng/ml). There was no difference in pregnancy rate between the two groups. Five out of 12 pregnant women exhibited AMH levels of less than 0.4 ng/ml. CONCLUSION(S): Assessment of serum AMH concentration in older patients is useful for the prediction of oocytes numbers which may be obtained in IVF. A cut-off level of 1.0 ng/ml AMH can be used to predict poor ovarian response. This cut-off level of AMH of 1.0 ng/ml might be useful to predict whether patients could have an embryo transfer, but had no power to predict achieving pregnancy. On the other hand, our data also showed that patients over age 40 with extreme low levels of AMH still had a chance of pregnancy.
PURPOSE: Although studies of serum anti-Müllerian hormone (AMH) in predicting ovarian reserve are numerous, many studies utilized patients under age 40. However, the assessment of ovarian reserve is especially critical in older infertile women. This study evaluates the significance of AMH level in patients over age 40 at the time of their first in vitro fertilization (IVF) treatment. METHODS: Forty-nine women over age 40 were studied. Although serum samples were taken prior to their IVF treatments, the data of serum AMH of patients were not taken into consideration to determine the therapy strategy, including follicle induction in which clomiphene citrate and human menopausal gonadotropin were used. RESULT(S): Twelve out of 49 patients achieved a clinical pregnancy (24.4 %). There was a positive correlation between serum AMH levels and the number of oocytes retrieved (P < 0.0001). The ROC curve analysis for prediction of poor ovarian response, ≤3 retrieved oocytes, showed that the optimum cut-off level was < 1.0 ng/mL for AMH. The lower AMH group (AMH < 1.0 ng/ml) showed less chance of undergoing embryo transfer than the higher AMH group (AMH ≥1.0 ng/ml). There was no difference in pregnancy rate between the two groups. Five out of 12 pregnant women exhibited AMH levels of less than 0.4 ng/ml. CONCLUSION(S): Assessment of serum AMH concentration in older patients is useful for the prediction of oocytes numbers which may be obtained in IVF. A cut-off level of 1.0 ng/ml AMH can be used to predict poor ovarian response. This cut-off level of AMH of 1.0 ng/ml might be useful to predict whether patients could have an embryo transfer, but had no power to predict achieving pregnancy. On the other hand, our data also showed that patients over age 40 with extreme low levels of AMH still had a chance of pregnancy.
Authors: I A J van Rooij; F J M Broekmans; E R te Velde; B C J M Fauser; L F J M M Bancsi; F H de Jong; A P N Themmen Journal: Hum Reprod Date: 2002-12 Impact factor: 6.918
Authors: S Lie Fong; E B Baart; E Martini; I Schipper; J A Visser; A P N Themmen; F H de Jong; B J C M Fauser; J S E Laven Journal: Reprod Biomed Online Date: 2008-05 Impact factor: 3.828
Authors: Christien Weenen; Joop S E Laven; Anne R M Von Bergh; Mark Cranfield; Nigel P Groome; Jenny A Visser; Piet Kramer; Bart C J M Fauser; Axel P N Themmen Journal: Mol Hum Reprod Date: 2004-02 Impact factor: 4.025
Authors: A La Marca; G Sighinolfi; D Radi; C Argento; E Baraldi; A Carducci Artenisio; G Stabile; A Volpe Journal: Hum Reprod Update Date: 2009-09-30 Impact factor: 15.610
Authors: Amani Khader; Suzanne M Lloyd; Alex McConnachie; Richard Fleming; Valentina Grisendi; Antonio La Marca; Scott M Nelson Journal: J Ovarian Res Date: 2013-01-07 Impact factor: 4.234
Authors: Z Heidar; M Bakhtiyari; M Mirzamoradi; S Zadehmodarres; F S Sarfjoo; M A Mansournia Journal: J Endocrinol Invest Date: 2015-05-17 Impact factor: 4.256
Authors: Joyce B da Silva; Tatiana R Panaino; Maria A Tamm; Paloma Lira; Patricia C F Arêas; Ana C A Mancebo; Marcelo M de Souza; Roberto A Antunes; Maria do Carmo B de Souza Journal: JBRA Assist Reprod Date: 2016-12-01