Early follicular antimüllerian hormone as an indicator of ovarian reserve

Objective

To determine the predictive value of antimüllerian hormone (AMH) as a marker for ovarian reserve and to compare its value with the markers currently being used.

Design

Prospective analysis.

Setting

In vitro fertilization (IVF) clinic of a tertiary medical center.

Patient(s)

Fifty women undergoing assisted reproduction cycles.

Intervention(s)

None.

Main Outcome Measure(s)

Comparison of day-3 serum AMH levels among women with less than five retrieved oocytes and five or more oocytes. Antral follicle count, mature oocyte count, age, basal follicle-stimulating hormone (FSH), estradiol (E₂), maximum serum E₂ levels, and pregnancy success were also compared.

Result(s)

The mean serum AMH levels of patients with more than five retrieved oocytes were found to be higher (0.67 ± 0.41 vs. 0.15 ± 0.11 pg/mL). Mature oocyte counts, antral follicle counts, and maximum E₂ levels were found to be statistically significantly different in the two groups despite similar ages and levels of basal FSH and E₂. Although the receiver operator characteristics analysis revealed that the most sensitive and specific indicator of ovarian reserve is the level of AMH, it does not indicate pregnancy success as well when 0.25 pg/mL is taken as a cut-off value.

Conclusion(s)

These data demonstrate an association between early follicular serum AMH and ovarian response, but no association with pregnancy success.

Key Words:  Serum antimüllerian hormone (AMH) , ovarian reserve