Serum antimüllerian hormone levels are independently related to miscarriage rates after in vitro fertilization–embryo transfer
Regardless of age and ovarian response to controlled ovarian stimulation, serum anti-m€ullerian hormone levels are associated with miscarriage rates following in vitro fertilization–embryo transfer.
Volume 108, Issue 3, Pages 518–524
Authors:
Bruno Tarasconi, M.D., Teddy Tadros, M.D., Jean-Marc Ayoubi, M.D., Ph.D., Stephanie Belloc, Pharm.D., Dominique de Ziegler, M.D., Renato Fanchin, M.D., Ph.D.
Abstract:
Objective
To investigate whether serum antimüllerian hormone (AMH) levels are independently related to miscarriage rates after in vitro fertilization–embryo transfer (IVF-ET).
Design
Cohort study.
Setting
University-affiliated IVF-ET center.
Patient(s)
A total of 1,060 patients who attained a clinical pregnancy after IVF-ET.
Interventions(s)
Centralized serum AMH measurements were performed within the 12 months before IVF-ET. Binary logistic regression was used to verify whether serum AMH levels were associated with the occurrence of a miscarriage independently from confounding factors, such as age and intensity of ovarian response to controlled ovarian stimulation assessed by the number of oocytes retrieved.
Main Outcome Measure(s)
Miscarriage rates.
Result(s)
In patients displaying reduced serum AMH levels, miscarriage rates were significantly increased independently from age and the number of oocytes retrieved.
Conclusion(s)
The present data indicate that serum AMH levels are independently associated with the occurrence of a miscarriage after IVF-ET.
Comments
This interesting study would suggest that in two women of the same age undergoing ART treatments, the one with the lower AMH level has the higher miscarriage risk.
Can the authors expand on the biological plausibility of this? In the paper, the underlying mechanism for the findings is thought to be "that lower serum AMH levels also reflect a relatively deficient
AMH production by unhealthy follicles that contain an incompetent oocyte".
Can we really extrapolate from the production of a hormone by the totality of antral follicle granulosa cells at baseline to the quality (and maybe even genetic status) of a cohort of oocytes at the end of stimulation? If yes is there more than empiric evidence for a biologic mechanism?