The predictability of serum anti-Müllerian level in IVF/ICSI outcomes for patients of advanced reproductive age

Reproductive Biology and Endocrinology

Research

Ming-Huei Lin¹  Shyr-Yeu Lin¹  Frank SY Wu¹  Robert KK Lee²  Yuh-Ming Hwu³ 

[1] Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan;Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan;Department of Obstetrics and Gynecology, Taipei Medical University, Taipei, Taiwan;Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan;Mackay Medicine, Nursing and Management College, Taipei, Taiwan;

关键词: Congenital Adrenal Hyperplasia;    Clinical Pregnancy;    Ovarian Reserve;    Clinical Pregnancy Rate;    Antral Follicle Count;   

DOI  :  10.1186/1477-7827-9-115

 received in 2011-05-06, accepted in 2011-08-15,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundThe role of serum anti-Müllerian hormone (AMH) as predictor of in-vitro fertilization outcomes has been much debated. The aim of the present study is to investigate the practicability of combining serum AMH level with biological age as a simple screening method for counseling IVF candidates of advanced reproductive age with potential poor outcomes prior to treatment initiation.MethodsA total of 1,538 reference patients and 116 infertile patients aged greater than or equal to 40 years enrolled in IVF/ICSI cycles were recruited in this retrospective analysis. A reference chart of the age-related distribution of serum AMH level for Asian population was first created. IVF/ICSI patients aged greater than or equal to 40 years were then divided into three groups according to the low, middle and high tertiles the serum AMH tertiles derived from the reference population of matching age. The cycle outcomes were analyzed and compared among each individual group.ResultsFor reference subjects aged greater than or equal to 40 years, the serum AMH of the low, middle and high tertiles were equal or lesser than 0.48, 0.49-1.22 and equal or greater than 1.23 ng/mL respectively. IVF/ICSI patients aged greater than or equal to 40 years with AMH levels in the low tertile had the highest cycle cancellation rate (47.6%) with zero clinical pregnancy. The nadir AMH level that has achieved live birth was 0.56 ng/mL, which was equivalent to the 36.4th percentile of AMH level from the age-matched reference group. The optimum cut-off levels of AMH for the prediction of nonpregnancy and cycle cancellation were 1.05 and 0.68 ng/mL, respectively.ConclusionsTwo criteria: (1) age greater than or equal to 40 years and (2) serum AMH level in the lowest tertile (equal or lesser than 33.3rd percentile) of the matching age group, may be used as markers of futility for counseling IVF/ICSI candidates.

【 授权许可】

Unknown   
© Lee et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.