Low antimüllerian hormone (AMH) is associated with decreased live birth after in vitro fertilization when follicle-stimulating hormone and AMH are discordant

Low AMH (<1 ng/mL) with normal FSH is associated with decreased live birth and higher cycle cancellation compared with normal AMH and elevated FSH (>10 mIU/mL) in women undergoing IVF.

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Volume 112, Issue 1, Pages 73–81.e1

Authors:

Sarah Ligon, M.D., Michael Lustik, M.S., Gary Levy, M.D., Bruce Pier, M.D.

Abstract:

Objective

To evaluate which factor, AMH or FSH, was superior in predicting live birth after assisted reproductive technologies (ART) when the tests are discordant, using data from the Society for Assisted Reproductive Technology Clinical Outcomes Reporting System database.

Design

Retrospective cohort.

Setting

Clinic-based data.

Patient(s)

The study population included 44,696 fresh embryo transfer cycles using autologous oocytes.

Intervention(s)

None.

Main Outcome Measure(s)

Live birth (≥22 wk gestation and ≥300 g birth weight).

Result(s)

Live birth rate per started cycle was lower in patients with low AMH and normal FSH than in patients with normal AMH and elevated FSH (26% vs. 39%). A multivariate analysis was performed on patients with normal FSH and low AMH, and the following factors were independently associated with live birth: AMH, age >40 years, body mass index >30 kg/m2, race African-American or Asian, IVF clinic region West, uterine factor infertility diagnosis, agonist suppression, and FSH dosage. IVF cycle cancellation rate was higher in patients with low AMH and normal FSH (30%).

Conclusion(s)

AMH is a superior predictor of live birth in patients undergoing IVF when FSH and AMH values are discordant. Lower AMH is independently associated with lower live birth and higher IVF cycle cancellation rates than elevated FSH in patients with discordant values.


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Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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