Clinical Pearls:
- Patients aged >34 years with low AMH levels displayed poorer IVF-ET outcome particularly, higher miscarriage rates that is not dependent on age and ovarian response to COH.
American
Society for Reproductive Medicine (ASRM) 2016 Scientific Congress is currently ongoing (October 15 – 19) at Salt Lake City, Utah. Some selected abstract
and news from the conference.
Anti-Müllerian
Hormone (AMH) has long been known to provide insight into ovarian function. It
is produced by small, growing follicles, thus providing us with quantitative
information on ovarian reserve.
While AMH levels
predict the treatment outcome in controlled ovarian hyperstimulation, no data
is available on its role in predicting miscarriages in patients undergoing
IVF-ET. [1]
Researchers are more and more interested to evaluate its role in oocyte
competence and embryo health.
Results of a
prospective study by Tarasconi B et al at the ASRM 2016 conference shows
the role played by levels of AMH and subsequent miscarriage rate in patients
undergoing IVF-ET. [2]
The paper is also published in a special supplement of Journal Fertility and Sterility.
The study
authors examined 2,365 infertile women undergoing 2,688 IVF-ET cycles. All the
women included in the study had serum AMH tested as reference with ELISA. Women
were classified into 3 age groups: ≤33 years (n=1,033), 34-36 years (n=690) and
≥37 years (n=965) and into 3 different AMH groups: Low AMH (0.04-1.60 ng/mL;
n=540), Intermediate AMH (1.61-5.59 ng/mL; n=1,608), and High AMH (5.60-35.00
ng/mL; n=540).
After
analyzing the data by binary logistic regression, it was seen that clinical pregnancy
and live birth rate were directly proportional to levels of AMH, with
miscarriage rate being highest in the low AMH level group.
The results
were statistically significant in older women in the two age groups of 34-36
years and ≥37 years.
When the
whole population was included as one variable, regression analysis showed direct
association between patient’s AMH levels and rate of miscarriages independent
of age and number of oocyte retrieved.
The study
findings support the hypothesis that AMH levels are biomarker of oocyte and embryo
reproductive health beside predicting number of oocyte obtained by COH.
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