September 2014 (No. 3)
Anti-Müllerian hormone (AMH) is a strong predictor of live birth in women undergoing assisted reproductive technology
Krzysztof Lukaszuk a,b,c,e, Joanna Liss a, Michal Kunicki c, Grzegorz Jakiel d, Tomasz Wasniewski e, Izabela Woclawek-Potocka f, Ewa Pastuszek a,b
a INVICTA Fertility and Reproductive Center, Gdansk, Poland
b Department of Nursing, Medical University, Gdansk, Poland
c INVICTA Fertility and Reproductive Clinic, Warsaw, Poland
d Department of Obstetrics and Gynaecology, The Medical Center of Postgraduate Education, Warsaw, Poland
e Department of Gynaecology and Obstetrics, Warmia and Masuria University, Olsztyn, Poland
f Department of Reproductive Immunology and Pathology, Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, Olsztyn, Poland
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.
Reproductive Biology 2014 14 3: 176-181.
* Corresponding author at: INVICTA Fertility and Reproductive Center, 10 Rajska Str., 80-850 Gdansk, Poland.. E-mail addresses: email@example.com, firstname.lastname@example.org (K. Lukaszuk)