Reshef Tal1, David B Seifer1, Renana Tal2, Emily Granger2, Ethan Wantman3, Oded Tal4. 1. Division of Reproductive Endocrinology & Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut, USA. 2. Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut, USA. 3. Redshift Technologies, New York, New York, USA. 4. School of Business, Conestoga College, Kitchener, Ontario, Canada.
Abstract
CONTEXT: Antimullerian hormone (AMH) level is strongly associated with ovarian response in reproductive technology (ART) cycles but is a poor predictor of live birth. It is unknown whether AMH is associated with cumulative live birth rates (CLBR) in women with diminished ovarian reserve (DOR). OBJECTIVE: To examine the association between serum AMH and CLBR among women with DOR undergoing ART. DESIGN: Retrospective analysis of Society for Assisted Reproductive Technology Clinic Outcome Reporting System database 2014-16. SETTING: Not applicable. PATIENTS: A total of 34,540 index retrieval cycles of women with AMH<1 ng/ml. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Cumulative live birth. RESULTS: A total of 34,540 (25.9%) cycles with AMH<1 ng/ml out of 133,442 autologous index retrieval cycles were analyzed. Cycles with preimplantation genetic testing or egg/embryo banking were excluded. Data was stratified according to AMH and age and regression analysis of AMH and CLBR was performed for each age strata. Multiple logistic regression demonstrated that AMH is an independent predictor of CLBR (Odds ratio 1.39, 95%CI 1.18-1.64). Serum AMH was strongly associated with number of oocytes retrieved, embryos cryopreserved, mean number of cumulative embryos transferred, and percentage of cycles that had an embryo transfer,. Linear regression analysis demonstrated that AMH highly correlated with CLBR in each age strata. CONCLUSIONS: Serum AMH is highly correlated with CLBR in women with DOR independent of age. The addition of AMH to current age-based prognostication counseling particularly in women with DOR would provide more informative and personalized CLBR prediction prior to ART.
CONTEXT: Antimullerian hormone (AMH) level is strongly associated with ovarian response in reproductive technology (ART) cycles but is a poor predictor of live birth. It is unknown whether AMH is associated with cumulative live birth rates (CLBR) in women with diminished ovarian reserve (DOR). OBJECTIVE: To examine the association between serum AMH and CLBR among women with DOR undergoing ART. DESIGN: Retrospective analysis of Society for Assisted Reproductive Technology Clinic Outcome Reporting System database 2014-16. SETTING: Not applicable. PATIENTS: A total of 34,540 index retrieval cycles of women with AMH<1 ng/ml. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Cumulative live birth. RESULTS: A total of 34,540 (25.9%) cycles with AMH<1 ng/ml out of 133,442 autologous index retrieval cycles were analyzed. Cycles with preimplantation genetic testing or egg/embryo banking were excluded. Data was stratified according to AMH and age and regression analysis of AMH and CLBR was performed for each age strata. Multiple logistic regression demonstrated that AMH is an independent predictor of CLBR (Odds ratio 1.39, 95%CI 1.18-1.64). Serum AMH was strongly associated with number of oocytes retrieved, embryos cryopreserved, mean number of cumulative embryos transferred, and percentage of cycles that had an embryo transfer,. Linear regression analysis demonstrated that AMH highly correlated with CLBR in each age strata. CONCLUSIONS: Serum AMH is highly correlated with CLBR in women with DOR independent of age. The addition of AMH to current age-based prognostication counseling particularly in women with DOR would provide more informative and personalized CLBR prediction prior to ART.
Authors: Hang Wun Raymond Li; David Mark Robertson; Chris Burns; William Leigh Ledger Journal: Front Endocrinol (Lausanne) Date: 2021-05-24 Impact factor: 5.555