Anti-Mullerian hormone (AMH) as predictor of ovarian reserve

Authors

  • Chaitanya Ashok Shembekar Department of Obstetrics and Gynecology, Omega Hospital, Nagpur, Maharashtra, India
  • Jayshree Jayant Upadhye Department of Obstetrics and Gynecology, Omega Hospital, Nagpur, Maharashtra, India
  • Manisha Chaitanya Shembekar Department of Anaesthesia, Omega Hospital, Nagpur, Maharashtra, India
  • Shravani H. Welekar Department of Embryology, Omega Hospital, Nagpur, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20174053

Keywords:

Anti-mullerian hormone, Antral follicular count, Oocytes

Abstract

Background: Anti-Müllerian hormone (AMH) is produced by the granulosa cells of preantral and small antral follicles and its levels can be assessed in serum. Since the number of ovarian follicles declines with increasing age, AMH levels might be used as a marker for ovarian ageing. Therefore, we studied the relationship between AMH levels and ovarian response during ovarian stimulation for In vitro fertilization.

Methods: A total of 100 patients who have undergone their ICSI treatment cycle using a GnRH antagonist protocol were retrospectively included. Co-relation between AMH and antral follicular count (AFC) was assessed.

Results: In present study, 36% patients had normal AMH, 18% patients were in low normal range, 5% patients had low values and 2% patients had very low values. 41% of patients had values in high range suggestive of PCOS. Amongst this, 21% had values between 4 to 8 ng/ml where we got good AFC count and good result in terms of pregnancy. 80% were good responders while 20% were poor responders. When we evaluated the relationship of retrieved oocyte counts with the parameters included, we found that only basal AMH levels and the number of antral follicles were statistically correlated.

Conclusions: High AMH levels correlated with low cancellation rates, retrieval of more eggs, higher live birth rates and a high chance for freezing of embryos. Low AMH levels (alone) do not predict low success rates in women under 35 years of age.

References

Chang HJ, Han SH, Lee JR, Jee BC, Lee BI, Suh CS, Kim SH. Impact of laparoscopic cystectomy on ovarian reserve: serial changes of serum anti-Müllerian hormone levels. Fertil Steril. 2010;94(1):343-9.

Hansen KR, Hodnett GM, Knowlton N, Craig LB. Correlation of ovarian reserve tests with histologically determined primordial follicle number. Fertility and sterility. 2011 Jan 31;95(1):170-5.

Visser JA, de Jong FH, Laven JS, Themmen AP. Anti-Müllerian hormone: a new marker for ovarian function. Reproduction. 2006 Jan 1;131(1):1-9.

Grynnerup AG, Lindhard A, Sørensen S. The role of anti-Müllerian hormone in female fertility and infertility – an overview. Acta Obstet Gynecol Scand. 2012;91:1252-60.

Tremellen KP, Kolo M, Gilmore A, Lekamge DN. Anti‐müllerian hormone as a marker of ovarian reserve. Aust N Z J Obstet Gynecol. 2005;45(1):20-4.

Karkanaki A, Vosnakis C, Panidis D. The clinical significance of anti-Müllerian hormone evaluation in gynecological endocrinology. Hormones. 2011;10(2):95-103.

Fiona McCulloch AMH. An Important Hormone Test for Women with PCOS, White lotus Integrative Medicine. 2015.

Fiçicioǧlu C, Kutlu T, Baglam E, Bakacak Z. Early follicular antimüllerian hormone as an indicator of ovarian reserve. Fertil Sterility. 2006;85(3):592-6.

Rooij V, Broekmans F. Serum anti-Müllerian hormone levels: a novel measure of ovarian reserve. Hum Reprod. 2002;17(12):3065-71.

Dillon KE, Sammel MD, Prewitt M, Ginsberg JP, Walker D, Mersereau JE, Gosiengfiao Y, Gracia CR. Pretreatment antimüllerian hormone levels determine rate of posttherapy ovarian reserve recovery: acute changes in ovarian reserve during and after chemotherapy. Fertil Steril. 2013;99(2):477-83.

Iwase A, Hirokawa W, Goto M, Takikawa S, Nagatomo Y, Nakahara T et al. Serum anti-Müllerian hormone level is a useful marker for evaluating the impact of laparoscopic cystectomy on ovarian reserve. Fertil Steril. 2010;94(7):2846-9.

Tremellen K, Zander‐Fox D. Serum anti‐Mullerian hormone assessment of ovarian reserve and polycystic ovary syndrome status over the reproductive lifespan. Aust N Z J Obstet Gynecol. 2015;55(4):384-9.

Brodin T, Hadziosmanovic N, Berglund L, Olovsson M, Holte J. Comparing four ovarian reserve markers–associations with ovarian response and live births after assisted reproduction. Acta Obstetricia et Gynecologica Scandinavica. 2015;94(10):1056-63.

Safier LZ, Grossman LC, Chan CW, Sauer MV, Lobo RA, Douglas NC. Use of anti‐Müllerian hormone testing during ovarian reserve screening to identify women at risk of polycystic ovary syndrome. Int J Gynecol Obstet. 2016;135(1):73-6.

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Published

2017-08-28

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Original Research Articles