1
|
Umarsingh S, Adam JK, Krishna SBN. The relationship between anti-Müllerian hormone (AMH) levels and pregnancy outcomes in patients undergoing assisted reproductive techniques (ART). PeerJ 2021; 8:e10390. [PMID: 33391866 PMCID: PMC7761264 DOI: 10.7717/peerj.10390] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 10/27/2020] [Indexed: 11/20/2022] Open
Abstract
A variety of predictors are available for ovarian stimulation cycles in assisted reproductive technology (ART) forecasting ovarian response and reproductive outcome in women including biomarkers such as anti- Müllerian hormone (AMH). The aim of our present study was to compare the relationship between AMH levels and pregnancy outcomes in patients undergoing intra-cytoplasmic sperm injection (ICSI). Overall, fifty patients (n = 50), aged 20-45 years were recruited for the present prospective study. Three AMH levels were presented with high often poly cystic ovarian syndrome (PCOS) amongst 52.4% patients, 40.5% in normal and 7.1% in low to normal, correspondingly. There was statistically significant relationship between AMH and day of embryo transfer (p < 0.05). The Pearson analysis between AMH, age, E2 and FSH displayed no statistically significant relationship between E2 and AMH (p < 0.05) and negative correlation between FSH and age (p > 0.05). The area under the receiver operating characteristic curve for E2 was 0.725 and for AMH levels as predictors of CPR was 0.497 indicating E2 as better predictor than AMH. The number of oocytes, mature oocytes and fertilized oocytes all presented a weak positive relationship to AMH. Our results confirm the clinical significance of AMH to accurately predict ovarian reserve as a marker and its limitations to use as predictor for a positive pregnancy outcome. Additional prospective studies should be conducted to validate the predictive capability of AMH levels for the outcome of clinical pregnancy.
Collapse
Affiliation(s)
- Shalini Umarsingh
- Biomedical and Clinical Technology, Faculty of Health Sciences, Durban University of Technology, Durban, South Africa
| | - Jamila Khatoon Adam
- Biomedical and Clinical Technology, Faculty of Health Sciences, Durban University of Technology, Durban, South Africa
| | - Suresh Babu Naidu Krishna
- Biomedical and Clinical Technology, Faculty of Health Sciences, Durban University of Technology, Durban, South Africa
| |
Collapse
|
2
|
Bas-Lando M, Rabinowitz R, Farkash R, Algur N, Rubinstein E, Schonberger O, Eldar-Geva T. Prediction value of anti-Mullerian hormone (AMH) serum levels and antral follicle count (AFC) in hormonal contraceptive (HC) users and non-HC users undergoing IVF-PGD treatment. Gynecol Endocrinol 2017; 33:797-800. [PMID: 28454495 DOI: 10.1080/09513590.2017.1320376] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Use of hormone contraceptives (HC) is very popular in the reproductive age and, therefore, evaluation of ovarian reserve would be a useful tool to accurately evaluate the reproductive potential in HC users. We conducted a retrospective cohort study of 41 HC users compared to 57 non-HC users undergoing IVF-preimplantation genetic diagnosis (PGD) aiming to evaluate the effect of HC on the levels of anti-Mullerian hormone (AMH), small (2-5 mm), large (6-10 mm) and total antral follicle count (AFC) and the ability of these markers to predict IVF outcome. Significant differences in large AFC (p = 0.04) and ovarian volume (p < 0.0001) were seen, however, there were no significant differences in small and total AFC or in serum AMH and FSH levels. Oocyte number significantly correlated with AMH and total AFC in HC users (p < 0.001) while in non-HC users these correlations were weaker. In HC users, the significant predictors of achieving <6 and >18 oocytes were AFC (ROC-AUC; 0.958, p = 0.001 and 0.883, p = 0.001) and AMH (ROC-AUC-0.858, p = 0.01 and 0.878, p = 0.001), respectively. The predictive values were less significant in non-HC users. These findings are important in women treated for PGD, in ovum donors and for assessing the fertility prognosis in women using HC and wishing to postpone pregnancy.
Collapse
Affiliation(s)
- Maayan Bas-Lando
- a Department of Obstetrics & Gynecology , Shaare Zedek Medical Center, Affiliated with the Hebrew University Hadassah School of Medicine , Jerusalem , Israel
| | - Ron Rabinowitz
- a Department of Obstetrics & Gynecology , Shaare Zedek Medical Center, Affiliated with the Hebrew University Hadassah School of Medicine , Jerusalem , Israel
| | - Rivka Farkash
- a Department of Obstetrics & Gynecology , Shaare Zedek Medical Center, Affiliated with the Hebrew University Hadassah School of Medicine , Jerusalem , Israel
| | - Nurit Algur
- a Department of Obstetrics & Gynecology , Shaare Zedek Medical Center, Affiliated with the Hebrew University Hadassah School of Medicine , Jerusalem , Israel
| | - Esther Rubinstein
- a Department of Obstetrics & Gynecology , Shaare Zedek Medical Center, Affiliated with the Hebrew University Hadassah School of Medicine , Jerusalem , Israel
| | - Oshrat Schonberger
- a Department of Obstetrics & Gynecology , Shaare Zedek Medical Center, Affiliated with the Hebrew University Hadassah School of Medicine , Jerusalem , Israel
| | - Talia Eldar-Geva
- a Department of Obstetrics & Gynecology , Shaare Zedek Medical Center, Affiliated with the Hebrew University Hadassah School of Medicine , Jerusalem , Israel
| |
Collapse
|
3
|
Aghssa MM, Tarafdari AM, Tehraninejad ES, Ezzati M, Bagheri M, Panahi Z, Mahdavi S, Abbasi M. Optimal cutoff value of basal anti-mullerian hormone in iranian infertile women for prediction of ovarian hyper-stimulation syndrome and poor response to stimulation. Reprod Health 2015; 12:85. [PMID: 26357853 PMCID: PMC4565016 DOI: 10.1186/s12978-015-0053-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Accepted: 07/04/2015] [Indexed: 11/12/2022] Open
Abstract
Aim We intended to establish the threshold of Anti-Mullerian Hormone (AMH) for detection of Ovarian Hyper-Stimulation Syndrome (OHSS) and poor response to treatment in Iranian infertile women. Methods Pre-stimulation menstrual cycle day-3 hormonal indices including basal AMH values were measured in 105 infertile women aged 32.5 ± 4.3 years. Patients underwent long GnRH agonist Controlled Ovarian Hyperstimulation (COH) in a referral infertility center (Tehran, Iran). The gonadotropin dose was determined based on the age and basal serum Follicular Stimulating Hormone (FSH) level. The IVF/ICSI cycles were followed and the clinical and sonographic data were recorded. Results Sixteen cases developed OHSS. The prevalence of PCOS was higher in subjects with OHSS [62.5 % (38.8-86.2) vs. 17 % (9.2-24.9)]. The patients with OHSS had higher ovarian follicular count [23.7 (3.2) vs. 9.1 (0.5); p < 0.05], collected oocytes [13.5 (1.9) vs. 6.9 (0.5); p < 0.05] and AMH level [7.9 (0.7) vs. 3.6 (0.3); p < 0.05]. Basal AMH level and oocyte yields (but not age, BMI, and PCOS) correlated with occurrence of OHSS; and only the AMH levels were associated with poor ovarian response (oocytes yield ≤ 4). The optimal cutoff value for the prediction of OHSS was 6.95 ng/ml (area under the receiver operating characteristics curve: 0.86; CI: 0.78-0.95; sensitivity: 75 %; specificity: 84 %; odds ratio for occurrence of OHSS: 9 and p < 0.001). The optimal cut point to discriminate poor response (oocytes ≤4) was 1.65 ng/ml ( AUC : 0.8; CI: 0.69-0.91; sensitivity: 89 % specificity : 71 %; and OR = 23.8 and P value <0.001). Conclusions Iranian women with basal AMH level > 6.95 ng/ml are at high risk of developing OHSS and those with AMH level < 1.65 ng/ml are poor responders.
Collapse
Affiliation(s)
- Malek Mansour Aghssa
- Vali-e-Asr Reproductive Health Research Center, Department of Obstetrics and Gynecology, Valiasr Hospital, Tehran University of Medical Sciences, 1419433141, Tehran, Iran.
| | - Azam Manshadi Tarafdari
- Vali-e-Asr Reproductive Health Research Center, Department of Obstetrics and Gynecology, Valiasr Hospital, Tehran University of Medical Sciences, 1419433141, Tehran, Iran.
| | - Ensieh Shahrokh Tehraninejad
- Vali-e-Asr Reproductive Health Research Center, Department of Obstetrics and Gynecology, Valiasr Hospital, Tehran University of Medical Sciences, 1419433141, Tehran, Iran.
| | - Mohammad Ezzati
- Department of Obstetrics and Gynecology, Washington Hospital Center, Washington, DC, USA.
| | - Maryam Bagheri
- Vali-e-Asr Reproductive Health Research Center, Department of Obstetrics and Gynecology, Valiasr Hospital, Tehran University of Medical Sciences, 1419433141, Tehran, Iran.
| | - Zahra Panahi
- Vali-e-Asr Reproductive Health Research Center, Department of Obstetrics and Gynecology, Valiasr Hospital, Tehran University of Medical Sciences, 1419433141, Tehran, Iran.
| | | | - Mehrshad Abbasi
- Department of Nuclear Medicine, Valiasr Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
4
|
Stuefer S, Moncayo H, Moncayo R. The role of magnesium and thyroid function in early pregnancy after in-vitro fertilization (IVF): New aspects in endocrine physiology. BBA CLINICAL 2015; 3:196-204. [PMID: 26675754 PMCID: PMC4661571 DOI: 10.1016/j.bbacli.2015.02.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Revised: 02/25/2015] [Accepted: 02/26/2015] [Indexed: 12/18/2022]
Abstract
Background The initiation of a pregnancy is a process that requires adequate energetic support. Recent observations at our Institution suggest a central role of magnesium in this situation. The aim of this study was to evaluate magnesium, zinc, selenium and thyroid function as well as anti-Müllerian hormone in early pregnancy following in-vitro fertilization as compared to spontaneous successful pregnancies. Results A successful outcome of pregnancy after IVF treatment was associated with 2 parameters: higher levels of anti-Müllerian hormone as well as higher levels of magnesium in the pre-stimulation blood sample. These two parameters, however, showed no correlation. Spontaneous pregnancies as well as pregnancies after IVF show a fall of magnesium levels at 2–3 weeks of gestation. This drop of magnesium concentration is larger following IVF as compared to spontaneous pregnancies. Parallel to these changes TSH levels showed an increase in early IVF-pregnancy. At this time point we also observed a positive correlation between fT4 and TSH. This was not observed in spontaneous pregnancies. Thyroid antibodies showed no correlation to outcomes. Conclusions In connection with the initiation of pregnancy following ovarian stimulation dynamic changes of magnesium and TSH levels can be observed. A positive correlation was found between fT4 and TSH in IVF pregnancies. In spontaneous pregnancies smaller increases of TSH levels are related to higher magnesium levels. General significance We propose that magnesium plays a role in early pregnancy as well as in pregnancy success independently from anti-Müllerian hormone. Neither thyroid hormones nor thyroid antibodies were related to outcome. Lack of correlation of thyroid function parameters to IVF outcome Significant drop of magnesium levels in early pregnancy after IVF Positive correlation between fT4 and TSH levels in early pregnancy following IVF Higher anti-Müllerian hormone levels are associated to successful IVF pregnancies. Higher magnesium levels are associated to successful IVF pregnancies.
Collapse
Affiliation(s)
| | - Helga Moncayo
- WOMED, Karl-Kapferer-Strasse 5, 6020 Innsbruck, Austria
| | - Roy Moncayo
- WOMED, Karl-Kapferer-Strasse 5, 6020 Innsbruck, Austria
| |
Collapse
|
5
|
Zhang H, Zhou Y, Li Y, Zheng Y, Xiao S, Wu Y, Wang H, Huang X. Prediction of clinical pregnancy in vitrified-warmed single blastocyst transfer cycles by pre-freeze morphology. IRANIAN JOURNAL OF REPRODUCTIVE MEDICINE 2014; 12:567-72. [PMID: 25408707 PMCID: PMC4233316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Accepted: 05/14/2014] [Indexed: 12/01/2022]
Abstract
BACKGROUND The selection of blastocyst warmed for transfer is based on pre-freeze morphology in vitrified-warmed single blastocyst transfer cycles. But, it is controversial which parameter of blastocyst morphology most closely related to the clinical outcomes. OBJECTIVE To estimate the effect of blastocoele expansion, trophectoderm (TE) morphology grade, and inner cell mass (ICM) morphology grade on clinical pregnancy in vitrified-warmed single blastocyst transfers. MATERIALS AND METHODS There were 172 vitrified-warmed single blastocyst transfer cycles during the year 2012 included in this analysis. Comparison of clinical results between pregnancy and no pregnancy group based on patient and blastocyst morphology characteristics was done. Then stepwise logistic regression analysis was used to select the best morphological predictor for clinical pregnancy. Last, comparison of patient characteristics and clinical outcomes separated by the best independent morphological predictor was done. RESULTS Comparison of clinical results between pregnancy and no pregnancy group and logistic regression showed the clinical pregnancy rate was affected by ICM. Comparison of patient characteristics separated by ICM grade, ICM grade A cycles got higher clinical pregnancy rate than ICM grade B cycles (54.3% vs. 35.0% respectively, p=0.037). CONCLUSION Blastocyst with good ICM morphology could increase clinical pregnancy rate in vitrified-warmed single blastocyst transfer cycles.
Collapse
|
6
|
Casadei L, Manicuti C, Puca F, Madrigale A, Emidi E, Piccione E. Can anti-Müllerian hormone be predictive of spontaneous onset of pregnancy in women with unexplained infertility? J OBSTET GYNAECOL 2014; 33:857-61. [PMID: 24219729 DOI: 10.3109/01443615.2013.831050] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The objective of the study was to assess anti-Müllerian hormone's (AMH) role in predicting spontaneous onset of pregnancy. This observational cohort study included 83 women with unexplained infertility and normal or low ovarian reserve. Serum AMH, FSH, LH, 17β-oestradiol, inhibin B levels were measured and the number of early antral follicles (2-9 mm) was evaluated on days 2-5 of the cycle. Spearman's correlation was used for comparison of strength of correlation. The diagnostic power of AMH in predicting spontaneous pregnancy was evaluated by receiver operating characteristic (ROC) curves. Markers of ovarian reserve in pregnant women and women without pregnancy were similar. In the entire study population, any markers (AMH, FSH, AFC, age), correlated with each other, but no marker was correlated with pregnancy. The area under the ROC curve for AMH reached a value of 0.385 ± 0.07 (0.25-0.52, 95% confidence interval, CI); for FSH 0.415 ± 0.08 (0.25-0.58, 95% CI); for AFC 0.418 ± 0.08 (0.26-0.57, 95% CI), for age 0.496 ± 0.08 (0.34-0.65, 95% CI). The study did not find a predictive role for AMH in predicting spontaneous onset of pregnancy. Even when AMH levels are very low, a spontaneous pregnancy may still occur.
Collapse
Affiliation(s)
- L Casadei
- Infertility Center, Section of Gynecology and Obstetrics, Academic Department of Biomedicine and Prevention and Clinical Department of Surgery, Tor Vergata University Hospital , Rome , Italy
| | | | | | | | | | | |
Collapse
|
7
|
Barcroft J, Dayoub N, Thong KJ. Fifteen year follow-up of embryos cryopreserved in cancer patients for fertility preservation. J Assist Reprod Genet 2013; 30:1407-13. [PMID: 23835721 DOI: 10.1007/s10815-013-0024-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2013] [Accepted: 05/27/2013] [Indexed: 11/28/2022] Open
Abstract
PURPOSE Determine the outcome of embryo cryopreservation in female oncology patients METHODS The outcomes of IVF/ICSI cycles in oncology patients over 15 years in a University Teaching Hospital. RESULTS Forty-two oncology patients (mean 31.9 ± 3.9 years) underwent embryo cryopreservation treatment (n = 33 IVF, n = 6 ICSI). Controlled ovarian stimulation with GnRH antagonist protocol (n = 34; 81 %) yielded fewer oocytes than GnRH agonist protocol (n = 8; 19 %) (9.4 ± 6.3 vs. 15.3 ± 8.9; p = 0.04) respectively. There was no significant difference in mean (±SD) duration of ovarian stimulation (11.6 ± 2.6 vs.10.6 ± 2.7), median gonadotrophin dose (1950 vs. 1670 IU), median day 5-6 oestradiol level (1124 vs.1129 pmol/l) or embryo yield (6.2 ± 4.1 vs. 8.8 ± 4.3; p = 0.07) between GnRH antagonist and agonist treatment cycles respectively. Thirty-nine patients cryopreserved embryos and three had their cycle cancelled. During this study period, of those who cryopreserved embryos, 5 patients underwent 9 frozen-thaw cycles (13 %), resulting in 2 live births (1 twin, 1 singleton, live birth rate 22 %). Six patients died (15 %), 3 conceived naturally (8 %) and 2 couples separated (5 %). Fourteen patients discarded their embryos (36 %). Twenty-two patients' (56 %) have embryos remaining in storage. CONCLUSIONS This study demonstrates that embryo cryopreservation in female oncology patients gives a satisfactory live birth rate. However, there are concerns regarding cost-effectiveness, resulting from high disposal/non-usage of embryos, and further studies are required.
Collapse
Affiliation(s)
- J Barcroft
- Edinburgh Assisted Conception Programme, Royal Infirmary of Edinburgh, Edinburgh, EH16 4SA, UK
| | | | | |
Collapse
|
8
|
Yilmaz N, Uygur D, Inal H, Gorkem U, Cicek N, Mollamahmutoglu L. Dehydroepiandrosterone supplementation improves predictive markers for diminished ovarian reserve: serum AMH, inhibin B and antral follicle count. Eur J Obstet Gynecol Reprod Biol 2013; 169:257-60. [PMID: 23664458 DOI: 10.1016/j.ejogrb.2013.04.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Revised: 02/15/2013] [Accepted: 04/12/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To evaluate the effect of dehydroepiandrosterone (DHEA) supplementation on ovarian reserve by measuring markers such as antral follicle count, serum anti-Müllerian hormone (AMH) and inhibin B in patients with diminished ovarian reserve. STUDY DESIGN This prospective study was undertaken at Dr. Zekai Tahir Burak Women's Health Research and Education Hospital, Ankara, Turkey. Forty-one patients with diminished ovarian reserve were included in the study and received supplementation with DHEA 25mg, t.i.d., for at least 6 weeks. Serum AMH, inhibin B, follicle-stimulating hormone (FSH) and oestradiol, and antral follicle count were determined before and after DHEA supplementation. Baseline ovarian reserve parameters such as antral follicle count, FSH, oestradiol, AMH, inhibin B, clinical and laboratory IVF outcomes, and pregnancy rates were studied. RESULTS There were significant differences in day 3 FSH, oestradiol, antral follicle count, AMH and inhibin B levels before and after DHEA supplementation in all patients (p=0.001, 0.001, 0.002, 0.001 and 0.001, respectively). The study population was divided into two age groups (<35 and ≥35 years) to determine whether there was a difference in the effect of DHEA supplementation between younger and older patients with diminished ovarian reserve. Significant differences were found in all of the parameters in both study groups (p<0.05). CONCLUSIONS DHEA supplementation is an effective option for patients with diminished ovarian reserve. Prior to assisted reproductive technology, patients with diminished ovarian reserve should be offered DHEA supplementation as an alternative to oocyte donation.
Collapse
Affiliation(s)
- N Yilmaz
- IVF Department, Zekai Tahir Burak Women's Health Research and Education Hospital, Ankara, Turkey.
| | | | | | | | | | | |
Collapse
|
9
|
Li HWR, Lee VCY, Lau EYL, Yeung WSB, Ho PC, Ng EHY. Role of baseline antral follicle count and anti-Mullerian hormone in prediction of cumulative live birth in the first in vitro fertilisation cycle: a retrospective cohort analysis. PLoS One 2013; 8:e61095. [PMID: 23637787 PMCID: PMC3634063 DOI: 10.1371/journal.pone.0061095] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Accepted: 03/05/2013] [Indexed: 11/29/2022] Open
Abstract
Objective This retrospective study determined for the first time the role of baseline antral follicle count (AFC) and serum anti-Mullerian hormone (AMH) level in the first in-vitro fertilisation (IVF) cycle in predicting cumulative live birth from one stimulation cycle. Methods We studied 1,156 women (median age 35 years) undergoing the first IVF cycle. Baseline AFC and AMH level on the day before ovarian stimulation were analysed. The main outcome measure was cumulative live birth in the fresh plus all the frozen embryo transfers after the same stimulation cycle. Results Serum AMH was significantly correlated with AFC. Both AMH and AFC showed significant correlation with age and ovarian response in the stimulated cycle and total number of transferrable embryos. Baseline AFC and serum AMH were significantly higher in subjects attaining a live birth than those who did not in the fresh stimulated cycle, as well as those attaining cumulative live birth. There was a significant trend of higher cumulative live birth rate in women with higher AMH or AFC. However, logistic regression revealed that both AMH and AFC were not significant predictors of cumulative live birth after adjusting for age and number of embryos available for transfer. Considering only one single predictor, the areas under the ROC curves for AMH (0.646, 95% CI 0.616–0.675) and age (0.648, 95% CI 0.618–0.677) were slightly higher than that for AFC (0.617, 95% CI 0.587–0.647) in predicting cumulative live birth. However, a model combining AMH (with or without AFC) and age of the women only classified an addition of less than 2% of subjects correctly compared to the model with age alone. Conclusion Baseline AFC and serum AMH have only modest predictive performance on the occurrence of cumulative live birth, and may not give additional value on top of the women's age.
Collapse
Affiliation(s)
- Hang Wun Raymond Li
- Department of Obstetrics and Gynaecology, Centre of Assisted Reproduction and Embryology, The University of Hong Kong, Queen Mary Hospital, Hong Kong
- * E-mail:
| | - Vivian Chi Yan Lee
- Department of Obstetrics and Gynaecology, Centre of Assisted Reproduction and Embryology, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Estella Yee Lan Lau
- Department of Obstetrics and Gynaecology, Centre of Assisted Reproduction and Embryology, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - William Shu Biu Yeung
- Department of Obstetrics and Gynaecology, Centre of Assisted Reproduction and Embryology, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Pak Chung Ho
- Department of Obstetrics and Gynaecology, Centre of Assisted Reproduction and Embryology, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Ernest Hung Yu Ng
- Department of Obstetrics and Gynaecology, Centre of Assisted Reproduction and Embryology, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| |
Collapse
|
10
|
Himabindu Y, Sriharibabu M, Gopinathan KK, Satish U, Louis TF, Gopinath P. Anti-mullerian hormone and antral follicle count as predictors of ovarian response in assisted reproduction. J Hum Reprod Sci 2013; 6:27-31. [PMID: 23869147 PMCID: PMC3713572 DOI: 10.4103/0974-1208.112377] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Revised: 06/02/2012] [Accepted: 07/28/2012] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The objective of this study was to test the hypothesis that AMH and antral follicle count (AFC) are good predictors of ovarian response to controlled ovarian stimulation and to compare them. MATERIALS AND METHODS This observational cross-sectional study included 56 subjects aged between 25 and 42 years who were enrolled between 1(st) January and 31(st) December 2010 for their first intracytoplasmic sperm injection (ICSI) program. Baseline hormone profiles including serum levels of Estradiol (E2), Follicle-stimulating hormone (FSH), Luteinizing hormone (LH), and Anti-mullerian Hormone (AMH) were determined on day 3 of the previous cycle. The antral follicle count measurements were performed on days 3-5 of the same menstrual cycle. Antral follicles within the bilateral ovaries between 2-6 mm were recorded. The subjects were treated with long protocol for ovarian stimulation. Ovulation was induced with 10,000 IU of human chorionic gonadotropin (hCG) when at least 3 follicles attained the size of more than 17 mm. Transvaginal oocyte retrieval was performed under ultrasound guidance 36 hours after hCG administration. An oocyte count less than 4 and absence of follicular growth with controlled ovarian hyper stimulation was considered as poor ovarian response. Oocyte count of 4 or more was considered as normal ovarian response. RESULTS Statistical analysis was performed using SPSS software trail version 16.0. Subjects were divided into 2 groups, depending on the ovarian response. The mean oocyte counts were 12.27 ± 6.06 and 2.22 ± 1.24 in normal and poor responders, respectively, (P = 001). Multiple regression analysis revealed AMH and antral follicle count as predictors of ovarian response (β coefficient ± SE for AMH was 1.618 ± 0.602 (P = 0.01) and for AFC, it was, 0.528 ± 0.175 (P = 0.004). AFC was found to be a better predictor of ovarian response compared to AMH in controlled ovarian hyper stimulation. CONCLUSION The observations made in this study revealed that both AMH and AFC are good predictors of ovarian response; AFC being a better predictor compared to AMH.
Collapse
Affiliation(s)
- Y Himabindu
- Department of Obstetrics and Gynacology, GSL Medical College and General Hospital, Rajahmundry, Andhra Pradesh, India
| | - M Sriharibabu
- Department of Medicine, GSL Medical College and General Hospital, Rajahmundry, Andhra Pradesh, India
| | - KK Gopinathan
- Center for Infertility Management and Assisted Reproduction, Edappal and Kochi, Kerala, India
| | - Usha Satish
- Center for Infertility Management and Assisted Reproduction, Edappal and Kochi, Kerala, India
| | - T Fessy Louis
- Center for Infertility Management and Assisted Reproduction, Edappal and Kochi, Kerala, India
| | - Parasuram Gopinath
- Center for Infertility Management and Assisted Reproduction, Edappal and Kochi, Kerala, India
| |
Collapse
|
11
|
Li HWR, Ng EHY, Wong BPC, Anderson RA, Ho PC, Yeung WSB. Correlation between three assay systems for anti-Müllerian hormone (AMH) determination. J Assist Reprod Genet 2012; 29:1443-6. [PMID: 23117477 PMCID: PMC3528883 DOI: 10.1007/s10815-012-9880-1] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Accepted: 10/16/2012] [Indexed: 12/01/2022] Open
Abstract
Purpose Analysis of anti-Müllerian hormone (AMH) is becoming of recognized importance in reproductive medicine, but assays are not standardized. We have evaluated the correlation between the new Gen II ELISA kit (Beckman-Coutler) and the older ELISA kits by Immunotech (IOT) and Diagnostic Systems Laboratories (DSL). Methods A total of 56 archived serum samples from patients with subfertility or reproductive endocrine disorders were retrieved and assayed in duplicate using the three AMH ELISA kits . The samples covered a wide range of AMH concentrations (1.9 to 142.5 pmol/L). Results We observed good correlations between the new (AMH Gen II) and old AMH assay kits by IOT and DSL (R2 = 0.971 and 0.930 respectively). The regression equations were AMH (Gen II) = 1.353 × AMH (IOT) + 0.051 and AMH (Gen II) = 1.223 × AMH (DSL) – 1.270 respectively. Conclusions AMH concentrations using the Gen II kit are slightly higher than those from the IOT and DSL kits. Standardization of assay results worldwide is urgently required but this analysis facilitates the interpretation of values obtained historically and in future studies using any of the 3 assays available. Meanwhile, adapting clinical cut-offs from previously published work by direct conversion is not recommended.
Collapse
Affiliation(s)
- Hang Wun Raymond Li
- Department of Obstetrics & Gynaecology, Queen Mary Hospital, The University of Hong Kong, 102 Pokfulam Road, Hong Kong, PR China.
| | | | | | | | | | | |
Collapse
|
12
|
GRYNNERUP ANNAGARCIAALIX, LINDHARD ANETTE, SØRENSEN STEEN. The role of anti-Müllerian hormone in female fertility and infertility - an overview. Acta Obstet Gynecol Scand 2012; 91:1252-60. [DOI: 10.1111/j.1600-0412.2012.01471.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
13
|
|
14
|
Trophectoderm morphology significantly affects the rates of ongoing pregnancy and miscarriage in frozen-thawed single-blastocyst transfer cycle in vitro fertilization. Fertil Steril 2012; 98:361-7. [DOI: 10.1016/j.fertnstert.2012.05.014] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Revised: 04/23/2012] [Accepted: 05/07/2012] [Indexed: 11/17/2022]
|
15
|
Honnma H, Baba T, Sasaki M, Hashiba Y, Oguri H, Fukunaga T, Endo T, Asada Y. Serum anti-Mullerian hormone levels affect the rate of ongoing pregnancy after in vitro fertilization. Reprod Sci 2012; 20:51-9. [PMID: 22814098 DOI: 10.1177/1933719112450329] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
We used logistic regression analysis to investigate the relationship between serum anti-Mullerian hormone (AMH) levels and the rate of ongoing pregnancy. Retrospective data were collected from 1043 women who had undergone their first cycle of in vitro fertilization (IVF), including 540 cycles of fresh embryo transfer and 503 cycles of frozen-thawed embryo transfer. The patients were divided into 4 groups based on the cutoff values from a receiver-operating characteristic curve: 0.0 to 12.4, 12.5 to 25.5, 25.6 to 44.1, and >44.2 pmol/L. After adjustment for multiple confounders, the serum AMH group was found to be significantly related to the rate of ongoing pregnancy in total cycles (0.0-12.4 vs 12.5-25.5 pmol/L; P = .0088, odds ratio, 1.909: vs 25.6-44.1 pmol/L; P = .0281, odds ratio, 2.109: vs >44.2 pmol/L; P = .0008, odds ratio, 2.840). In conclusion, there appears to be a significant relationship between serum AMH levels and the ongoing pregnancy rate in first IVF treatment cycles after adjustment for multiple confounders.
Collapse
|
16
|
Capkın Sİ, Ozyer S, Karayalçın R, Moraloğlu O, Ozcan S, Uğur M. Serum and follicular fluid Anti-Mullerian hormone concentrations at the time of follicle puncture and reproductive outcome. J Turk Ger Gynecol Assoc 2012; 13:21-6. [PMID: 24627670 DOI: 10.5152/jtgga.2011.71] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2011] [Accepted: 10/19/2011] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The objective of the study is to determine and compare the levels of Anti-Mullerian hormone (AMH) and estradiol (E2) in serum and follicular fluid (FF) on the day of oocyte pick up (OPU) with the cycle parameters and the outcome of in vitro fertilization (IVF) treatment. MATERIAL AND METHODS The long stimulation protocol was used in 37 (86%) women; the microdose flare-up protocol was used in 6 (14%) women. Concentrations of AMH and E2 were measured in serum and FF of 43 women undergoing IVF treatment on the day of OPU. RESULTS Significant positive associations were observed between serum AMH concentrations and the total number of oocytes retrieved (r=0.343, p=0.024). Serum AMH and FF AMH levels on the day of OPU were significantly increased in the group of women who achieved clinical pregnancy (p=0.017, p=0.028). For serum AMH, a cut-off level of 1.64 ng/ml was used for the prediction of clinical pregnancy; for FF AMH, a cut-off level of 3.8 ng/ml was used for the prediction of clinical pregnancy. Serum AMH and FF AMH levels were significantly and positively correlated with implantation rate (r=0.401, p=0.008; r=0.317, p=0.039). No significant correlation was found between serum and FF AMH concentrations and fertilization rate. CONCLUSION Serum AMH and FF AMH concentrations are positively correlated with implantation and clinical pregnancy rates.
Collapse
Affiliation(s)
- Selma İnat Capkın
- Zekai Tahir Burak Women's Health Education and Research Hospital, IVf Unit, Ankara, Turkey
| | - Sebnem Ozyer
- Zekai Tahir Burak Women's Health Education and Research Hospital, IVf Unit, Ankara, Turkey
| | - Rana Karayalçın
- Zekai Tahir Burak Women's Health Education and Research Hospital, IVf Unit, Ankara, Turkey
| | - Ozlem Moraloğlu
- Zekai Tahir Burak Women's Health Education and Research Hospital, IVf Unit, Ankara, Turkey
| | - Sarp Ozcan
- Zekai Tahir Burak Women's Health Education and Research Hospital, IVf Unit, Ankara, Turkey
| | - Mustafa Uğur
- Zekai Tahir Burak Women's Health Education and Research Hospital, IVf Unit, Ankara, Turkey
| |
Collapse
|
17
|
Long-term endocrine side effects of childhood Hodgkin's lymphoma treatment: a review. Hum Reprod Update 2011; 18:12-28. [DOI: 10.1093/humupd/dmr038] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|