Negligible serum anti-müllerian hormone: pregnancy and birth after a 1-month course of an oral contraceptive, ovarian hyperstimulation, and intracytoplasmic sperm injection

Objective

To describe a patient with isolated negligible (<0.5 ng/mL or <3.6 pmol/L) anti-müllerian hormone (AMH) levels who underwent intracytoplasmic sperm injection (ICSI) for severe oligoasthenoteratozoospermia, displayed ovarian hyperstimulation after a 1-month course of an oral contraceptive (OC), had a singleton pregnancy and delivered a healthy boy.

Design

Case report.

Setting

Reproductive center at a private hospital.

Patient(s)

A 34-year-old woman with isolated negligible (<0.5 ng/mL or <3.6 pmol/L) AMH level and poor response to controlled ovarian hyperstimulation (COH) and her 38-year-old partner with severe oligoasthenoteratozoospermia.

Intervention(s)

A 1-month course of an OC, modified minimal stimulation cycle with recombinant FSH, antagonist (cetrorelix) administration to inhibit LH surge, triggered ovulation using 10,000 U of hCG and ICSI.

Main Outcome Measure(s)

Level of AMH, pregnancy, and birth.

Result(s)

Three high quality embryos were obtained and transferred 48 hours after ICSI. Transvaginal ultrasound at 8 weeks' gestation showed a vital singleton pregnancy. The pregnancy continued uncomplicated. The patient gave birth to a healthy boy, weighing 3,280 g, by caesarean section at 39 weeks' gestation.

Conclusion(s)

Ovarian hyperstimulation, pregnancy, and birth may occur after a short course of an OC and ICSI in poor responder, normogonadotropic, regularly menstruating young women with isolated negligible AMH.

Key Words: Anti-Müllerian hormone, hyperstimulation, ICSI, pregnancy, birth