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Anti-Müllerian hormone (AMH) is a strong predictor of live birth in women undergoing assisted reproductive technology
Institution:1. Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran;2. Obstetrics and Gynecology Department, Faculty of Medicine, Iran University of Medical Science, Tehran, Iran;3. Department of Gynecology and Obstetrics, Roointan Arash Women''s Health Research and Educational Hospital, Tehran University of Medical Sciences, Tehran, Iran;4. Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran;1. Human Reproduction and Genetics Center, Department of Collective Health, Faculdade de Medicina do ABC, Santo André, SP, Brazil;2. Clinical Laboratory, Department of Clinical Medicine, Faculdade de Medicina do ABC, Santo André, SP, Brazil
Abstract:In the present study, we evaluated the clinical value of the following parameters: basal anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), inhibin B and antral follicle count (AFC) in predicting live birth outcomes. The study involved 603 women undergoing in vitro fertilization (IVF) using the long protocol for controlled ovarian hyperstimulation (COH). Serum levels of AMH, FSH and inhibin B as well as AFC were measured on the first three days of the menstrual cycle prior to the beginning of stimulation. AMH was the only independent parameter that correlated with the chance of live birth. We found that live birth rates of 46.2% (patient age <35 years), 44.7% (35–37 years), 32.1% (38–39) and 15.3% (>39) were associated with concentrations of AMH > 1.4 ng/ml. For the AMH range 0.6–1.4 ng/ml, the live birth rates were 29.3%, 12.5%, 5.6% and 2.7%, respectively, and for AMH concentrations below 0.6 ng/ml the rates were 7.1%, 8.3%, 0% and 5.8%, respectively. Independently of other parameters affecting the chance of live birth, the success rate was the highest when the AMH level was >2 ng/ml, significantly lower when the AMH concentration was about 1 ng/ml, and 0% when the AMH concentration was ∼0.1 ng/ml. In conclusion, this is the first report to demonstrate that AMH level correlated better than age, FSH or inhibin B concentrations or AFC with live birth outcome. Therefore, the basal serum concentration of AMH may become a new, substantial prognostic factor regarding live birth above and beyond other currently available predictors of IVF outcome.
Keywords:Anti-Müllerian hormone  Antral follicle count  Controlled ovarian hyperstimulation  In vitro fertilization  Assisted reproductive technology
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