DO SERUM ANTI-MULLERIAN HORMON LEVELS ASSOCIATE WİTH ASSISTED REPRODUCTIVE TREATMENT CYCLE OUTCOMES? A RETROSPECTIVE ANALYSİS OF 1544 CYCLES FORM A SINGLE IVF CENTER

Öz

Anahtar Kelimeler

• AMH
• ICSI
• clinical pregnancy
• live birth
• AMH, ICSI, clinical pregnancy, live birth

DO SERUM ANTI-MULLERIAN HORMON LEVELS ASSOCIATE WİTH ASSISTED REPRODUCTIVE TREATMENT CYCLE OUTCOMES? A RETROSPECTIVE ANALYSİS OF 1544 CYCLES FORM A SINGLE IVF CENTER

Öz

Introduction: To evaluate whether there is a predictive value of serum Anti-Mullerian Hormone (AMH) levels on ovarian response and pregnancy outcomes of infertile women undergoing intracytoplasmic sperm injection (ICSI) cycle. Methods: A total of 1544 consecutive ICSI cycles of women aged between 18-45 years, performed in a single tertiary In-Vitro Fertilization (IVF) Center between 2015-2018, were retrospectively analyzed. Along with patients' ages and AMH levels, cycle characteristics, clinical pregnancy and live birth outcomes were evaluated. Age and serum AMH levels were categorized. Regression analyses were used to determine the predictive value of AMH on the ovarian response and clinical pregnancy/live birth outcomes. Results: Among 1544 cycles, 1306 (84.6%) were ended with an embryo transfer cyle. AMH levels were found significantly positively correlated with the numbers of obtained oocytes and 2-pronuclear(2pn) zygotes. AMH value of >1 ng/ml was significantly and independently associated with obtaining more than 5 oocytes (OR: 6.7; 95% CI: 4.9-9.1). The clinical pregnancy and live birth rates per cycle were significantly lower in patients with low AMH for both age <35 and above 35 years groups. However, live birth rates per embryo transfers were not significantly different(25.6% vs 32.8%, p=0.065 for women <35 years age and 17.8% vs 21.8%, p=0.273 for women >=35 years age). Moreover, only age and number of metaphase-2 oocytes were found significant independent predictors for live birth outcome. Conclusion: Although AMH levels are highly correlated with the oocyte yield in ICSI cycles, the ability to predict clinical pregnancy and live births for fresh embryo transfer cycles seems limited. Keywords: AMH, ICSI, clinical pregnancy, live birth

Anahtar Kelimeler

• AMH
• ICSI
• clinical pregnancy
• live birth

Kaynakça

1. 1. Practice Committee of the American Society for Reproductive Medicine. Electronic address: [e-mail]; Practice Committee of the American Society for Reproductive Medicine. Testing and interpreting measures of ovarian reserve: a committee opinion. Fertil Steril. 2020;114(6):1151-1157.
2. 2. te Velde ER, Pearson PL. The variability of female reproductive ageing. Hum Reprod Update 2002;8:141–154
3. 3. Broekmans FJ, Kwee J, Hendriks DJ, Mol BW, Lambalk CB. A systematic review of tests predicting ovarian reserve and IVF outcome. Hum Reprod Update. 2006;12(6):685-718.
4. 4. La Marca A, Sighinolfi G, Giulini S, Traglia M, Argento C, Sala C, et al. Normal serum concentrations of anti-Müllerian hormone in women with regular menstrual cycles. Reprod Biomed Online. 2010;21(4):463-9.
5. 5. Dewailly D, Andersen CY, Balen A, Broekmans F, Dilaver N, Fanchin R, et al. The physiology and clinical utility of anti-Mullerian hormone in women. Hum Reprod Update. 2014 May-Jun;20(3):370-85. Erratum in: Hum Reprod Update. 2014;20(5):804.
6. 6. de Vet A, Laven JS, de Jong FH, Themmen AP, Fauser BC. Antimüllerian hormone serum levels: a putative marker for ovarian aging. Fertil Steril. 2002;77(2):357-62.
7. 7. La Marca A, De Leo V, Giulini S, Orvieto R, Malmusi S, Giannella L, et al. Anti-Mullerian hormone in premenopausal women and after spontaneous or surgically induced menopause. J Soc Gynecol Investig. 2005;12(7):545-8.
8. 8. Lie Fong S, Visser JA, Welt CK, de Rijke YB, Eijkemans MJ, Broekmans FJ, et al. Serum anti-müllerian hormone levels in healthy females: a nomogram ranging from infancy to adulthood. J Clin Endocrinol Metab. 2012;97(12):4650-5.

9. 9. La Marca A, Sighinolfi G, Radi D, Argento C, Baraldi E, Artenisio AC, et al. Anti-Mullerian hormone (AMH) as a predictive marker in assisted reproductive technology (ART). Hum Reprod Update. 2010;16(2):113-30.
10. 10. Broer SL, van Disseldorp J, Broeze KA, Dolleman M, Opmeer BC, Bossuyt P, et al.; IMPORT study group. Added value of ovarian reserve testing on patient characteristics in the prediction of ovarian response and ongoing pregnancy: an individual patient data approach. Hum Reprod Update. 2013;19(1):26-36.