Relationship Between Anti-Müllerian Hormone and In Vitro Fertilization-Embryo Transfer in Clinical Pregnancy

Xing Yu Sun, Yun Zhu Lan, Shuang Liu, Xiao Ping Long, Xi Guang Mao, Ling Liu, Xing Yu Sun, Yun Zhu Lan, Shuang Liu, Xiao Ping Long, Xi Guang Mao, Ling Liu

Abstract

Objectives: To retrospectively analyze the correlation between anti-Müllerian hormone (AMH) and the number of oocytes obtained by controlled ovarian hyperstimulation (COH) in women of different ages and explore the factors affecting in vitro fertilization and embryo transfer (IVF-ET) in clinical pregnancy of infertile women to provide evidence for infertile women to choose assisted reproduction strategies.

Methods: Infertile women who received IVF-ET or intracytoplasmic sperm injection and embryo transfer (ICSI-ET) treatment in the reproductive center of XX hospital between October 2018 and September 2019 were included. Patient data on medical records, age, body mass index (BMI), years of infertility, basic follicle-stimulating hormone (FSH), basic luteinizing hormone (LH), basic estradiol (E2), anti-Müllerian hormone level (AMH), antral follicle count (AFC), gonadotropins (Gn) medication days, Gn dosage, endometrial thickness on transplantation day, the number of retrieved oocytes, the number of mature oocytes obtained, the number of embryos transferred, clinical pregnancy status, etc., were collected.

Results: A total of 314 patients were enrolled in this study, with an average age of 31.0 ± 4.5 years. The infertility period ranged from 0-21 years. The AMH level showed a downward trend with increasing age. Overall, the AMH level of women of all ages was positively correlated with the number of retrieved oocytes (r = 0.335, p < 0.001). The AMH level of women between 22 and 28 years old was positively correlated with the number of retrieved oocytes (r = 0.164, p < 0.061) but it was not statistically significant. Similarly, the AMH level of women aged 29-35 and 36-43 was positively correlated with the number of retrieved oocytes (r = 0.356, p < 0.001; r = 0.461, p < 0.001). The average age of the pregnant group (30.6 ± 4.4 years) was lower than that of the non-pregnant group (32.2 ± 4.6 years) (p < 0.001). The number of oocytes obtained (9.8 ± 4.5) and the number of embryos transferred (1.9 ± 0.4) in the pregnant group was significantly higher than that in the non-pregnant group (9.2 ± 4.5; 1.7 ± 0.5); the difference was statistically significant. The multivariate logistic regression model showed that age (OR = 0.574 95% CI: 0.350-0.940), AMH (OR = 1.430 95% CI: 1.130-1.820) and the number of oocytes obtained (OR = 1.360 95% CI: 1.030-1.790) were factors affecting clinical pregnancy.

Conclusion: We found that the level of AMH in infertile women decreased with age and the number of oocytes obtained in infertile women was positively correlated with AMH. Moreover, the number of oocytes and embryo transferred in the pregnant group was significantly higher than those in the non-pregnant group. Furthermore, age, AMH and the number of oocytes affected the clinical pregnancy.

Keywords: anti-Müllerian hormone; assisted reproductive technologies; in vitro fertilization-embryo transfer; infertile women; pregnancy.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2020 Sun, Lan, Liu, Long, Mao and Liu.

Figures

Figure 1
Figure 1
AMH levels in women of different ages.
Figure 2
Figure 2
Relationship between AMH levels and the number of retrieved oocytes in different age groups. (A) Overall relationship. (B) 22–28 years. (C) 29–35 years. (D) 36–43 years.

References

    1. Iliodromiti S, Kelsey TW, Wu O, Anderson RA, Nelson SM. The predictive accuracy of anti-Müllerian hormone for live birth after assisted conception: a systematic review and meta-analysis of the literature. Hum Reprod Update (2014) 20(4):560–70. 10.1093/humupd/dmu003
    1. Pilsgaard F, Grynnerup AG, Løssl K, Bungum L, Pinborg A. The use of anti-Mullerian hormone for controlled ovarian stimulation in assisted reproductive technology, fertility assessment and -counseling. Acta Obstet Gynecol Scand (2018) 97(9):1105–13. 10.1111/aogs.13334
    1. La Marca A, Stabile G, Artenisio AC, Volpe A. Serum anti-Mullerian hormone throughout the human menstrual cycle. Hum Reprod (2006) 21(12):3103–7. 10.1093/humrep/del291
    1. Massarotti C, La Pica V, Sozzi F, Scaruffi P, Remorgida V, Anserini F. Influence of age on response to controlled ovarian stimulation in women with low levels of serum anti-Müllerian hormone. Gynecol Endocrinol (2020) 9:1–5. 10.1080/09513590.2020.1737668
    1. Younis JS, Iskander R, Fauser BCJM, Izhaki I. Does an association exist between menstrual cycle length within the normal range and ovarian reserve biomarkers during the reproductive years? A systematic review and meta-analysis. Hum Reprod Update (2020) 26(6):904–28. 10.1093/humupd/dmaa013
    1. Ebner T, Sommergruber M, Moser M, Shebl O, Schreier-Lechner E, Tews E. Basal level of the anti-Mullerian hormone is associated with oocyte quality in stimulated cycles. Hum Reprod (2006) 21(8):2022–6. 10.1093/humrep/del127
    1. Lamazou F, Fuchs F, Grynberg M, Gallot V, Herzog E, Fanchin R, et al. Cancellation of IVF-ET cycles: poor prognosis, poor responder, or variability of the response to controlled ovarian hyperstimulation? An analysis of 142 cancellations. J Gynecol Obstet Biol Reprod (Paris) (2012) 41(1):41–7. 10.1016/j.jgyn.2011.06.001
    1. Gomez R, Schorsch M, Hahn T, Henke A, Hoffmann I, Seufert T, et al. The influence of AMH on IVF success. Arch Gynecol Obstet (2016) 293(3):667–73. 10.1007/s00404-015-3901-0
    1. Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod (2004) 19(1):41–7. 10.1093/humrep/deh098
    1. La Marca A, Giulini S, Tirelli A, Bertucci E, Marsella T, Xella S, et al. Anti-Mullerian hormone measurement on any day of the menstrual cycle strongly predicts ovarian response in assisted reproductive technology. Hum Reprod (2007) 22(3):766–71. 10.1093/humrep/del421
    1. Kastora SL, Triantafyllidou O, Kolovos G, Kastoras A, Sigalos G, Vlahos N. Combinational approach of retrospective clinical evidence and transcriptomics highlight AMH superiority to FSH, as successful ICSI outcome predictor. J Assist Reprod Genet (2020) 37(7):1623–35. 10.1007/s10815-020-01802-w
    1. Xu H, Shi L, Feng G, Xiao Z, Chen L, Li R, et al. An Ovarian Reserve Assessment Model Based on Anti-MMllerian Hormone Levels, Follicle-Stimulating Hormone Levels, and Age: Retrospective Cohort Study. J Med Internet Res (2020) 22(9):e19096. 10.2196/19096
    1. Lin YC, Chang SY, Lan KC, Huang HW, Chang CY, Tsai MY, et al. Human oocyte maturity in vivo determines the outcome of blastocyst development in vitro. J Assist Reprod Genet (2003) 20(12):506–12. 10.1023/b:jarg.0000013651.37866.0c
    1. Seifer DB, Baker VL, Leader B. Age-specific serum anti-Müllerian hormone values for 17,120 women presenting to fertility centers within the United States. Fertil Steril (2011) 95(2):747–50. 10.1016/j.fertnstert.2010.10.011
    1. Cui Y, Shi Y, Cui L, Han T, Gao X, Chen ZJ. Age-specific serum antimullerian hormone levels in women with and without polycystic ovary syndrome. Fertil Steril (2014) 102(1):230–6.e2. 10.1016/j.fertnstert.2014.03.032
    1. Masse V, Ferrari P, Boucoiran I, Delotte J, Isnard V, Bongain A. Normal serum concentrations of anti-Müllerian hormone in a population of fertile women in their first trimester of pregnancy. Hum Reprod (2011) 26(12):3431–6. 10.1093/humrep/der320
    1. Anckaert E, Smitz J, Schiettecatte J, Klein BM, Arce JC. The value of anti-Mullerian hormone measurement in the long GnRH agonist protocol: association with ovarian response and gonadotrophin-dose adjustments. Hum Reprod (2012) 27(6):1829–39. 10.1093/humrep/des101
    1. Patrelli TS, Gizzo S, Sianesi N, Levati L, Pezzuto A, Ferrari B, et al. Anti-Müllerian hormone serum values and ovarian reserve: can it predict a decrease in fertility after ovarian stimulation by ART cycles? PloS One (2012) 7(9):e44571. 10.1371/journal.pone.0044571
    1. Reichman DE, Goldschlag D, Rosenwaks Z. Value of antimullerian hormone as a prognostic indicator of in vitro fertilization outcome. Fertil Steril (2014) 101(4):1012–8. 10.1016/j.fertnstert.2013.12.039
    1. Borges E, Braga DPAF, Setti A, Figueira RC, Iaconelli A., Jr The predictive value of serum concentrations of anti-Müllerian hormone for oocyte quality, fertilization, and implantation. JBRA Assist Reprod (2017) 21(3):176–82. 10.5935/1518-0557.20170035
    1. Nelson SM, Yates RW, Fleming R. Serum anti-Müllerian hormone and FSH: prediction of live birth and extremes of response in stimulated cycles-implications for individualization of therapy. Hum Reprod (Oxford England) (2007) 22(9):2414–21. 10.1093/humrep/dem204
    1. Ng EH, Tang OS, Ho PC. The significance of the number of antral follicles before stimulation in predicting ovarian responses in an IVF programme. Hum Reprod (Oxford England) (2000) 15(9):1937–42. 10.1093/humrep/15.9.1937
    1. Broer SL, Broekmans FJ, Laven JS, Fauser BC. Anti-Müllerian hormone: ovarian reserve testing and its potential clinical implications. Hum Reprod Update (2014) 20(5):688–701. 10.1093/humupd/dmu020
    1. Lee RK, Wu FS, Lin MH, Lin SY, Hwu YM. The predictability of serum anti-Müllerian level in IVF/ICSI outcomes for patients of advanced reproductive age. Reprod Biol Endocrinol (2011) 9:115. 10.1186/1477-7827-9-115
    1. Gleicher N, Weghofer A, Barad DH. Anti-Müllerian hormone (AMH) defines, independent of age, low versus good live-birth chances in women with severely diminished ovarian reserve. Fertil Steril (2010) 94(7):2824–7. 10.1016/j.fertnstert.2010.04.067
    1. La Marca A, Nelson SM, Sighinolfi G, Manno M, Baraldi E, Roli L, et al. Anti-Müllerian hormone-based prediction model for live birth in assisted reproduction. Reprod Biomed Online (2011) 22(4):341–9. 10.1016/j.rbmo.2010.11.005

Source: PubMed

Szponzorok és közreműködők

Egészségi állapot

Kábítószer-beavatkozások

3
Iratkozz fel