Abstract
Purpose
To investigate whether serum Anti- Müllerian hormone (AMH) on day 3 could predict controlled ovarian stimulation and reproductive outcomes in women with polycystic ovary syndrome.
Methods
A total of 164 PCOS patients undergoing their first IVF treatment cycle were prospectively included. Serum AMH levels on cycle day 3 was measured. The controlled ovarian stimulation and clinical outcomes for the study population were divided according to the <25th, 25 to 75th, or >75th percentile of serum day-3 AMH.
Results
Estradiol levels on hCG day and the number of retrieved oocytes significantly increased with increasing serum AMH levels, while total consumption of gonadotropin dose showed a significant decrease (P < 0.05). Fertilization rate and the number of good quality embryos were comparable among the low, average and high groups (P > 0.05). Embryo implantation rates in the high AMH group was significantly inferior to those with low and average AMH concentration (27 versus 48.8 and 50%, P < 0.01). Clinical pregnancy rates was lower in the high AMH group than that of the low and average group (45.9 versus 65 and 66.7%, P = 0.09), but this difference was only close to statistical significance. In addition, ordinal regression analysis indicated that LH level was the only independent predictor of embryo implantation rates (P = 0.017).
Conclusions
In PCOS women, AMH levels on day 3 of the IVF stimulation cycle positively predict ovarian response to gonadotrophins. However, the women with high AMH levels had a significantly decreased IR, which may be due to remarkably increased LH concentrations.
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References
Van Rooij IA, Broekmans FJ, Te Velde ER, Fauser BC, Bancsi LF, De Jong FH, et al. Serum anti-Mullerian hormone levels: a novel measure of ovarian reserve. Hum Reprod. 2002;17:3065–71.
Cook CL, Siow Y, Brenner AG, Fallat ME. Relationship between serum Mullerian-inhibiting substance and other reproductive hormones in untreated women with polycystic ovary syndrome and normal women. Fertil Steril. 2002;77:141–6.
Laven JS, Mulders AG, Visser JA, Themmen AP, Jong FH, Fauser BC. Anti-Mullerian hormone serum concentrations in normovulatory and anovulatory women of reproductive age. J Clin Endocrinol Metab. 2004;89:318–23.
Norman RJ, Dewailly D, Legro RS, Hickey TE. Polycystic ovary syndrome. Lancet. 2007;370:685–97.
Pigny P, Jonard S, Robert Y, Dewailly D. Serum anti-Mullerian hormone as a surrogate for antral follicle count for definition of the polycystic ovary syndrome. J Clin Endocrinol Metab. 2006;91:941–5.
Pigny P, Merlen E, Robert Y, Cortet-Rudelli C, Decanter C, Jonard S, et al. Elevated serum level of anti-mullerian hormone in patients with polycystic ovary syndrome: relationship to the ovarian follicle excess and to the follicular arrest. J Clin Endocrinol Metab. 2003;88:5957–62.
Das M, Gillott DJ, Saridogan E, Djahanbakhch O. Anti-Mullerian hormone is increased in follicular fluid from unstimulated ovaries in women with polycystic ovary sundrome. Hum Reprod. 2008;23:2122–6.
La Marca A, Orvieto R, Giulini S, Jasonni VM, Volpe A, De Leo V. Mullerian-inhibiting substance in women with polycystic ovary syndrome: relationship with hormonal and metabolic characteristics. Fertil Steril. 2004;82:970–2.
Piouka A, Farmakiotis D, Katsikis I, Macut D, Gerou S, Panidis D. Anti-Mullerian hormone levels reflect severity of PCOS but are negatively influenced by obesity: relationship with increased luteinizing hormone levels. Am J Physiol Endocrinol Metab. 2009;296:238–43.
Nardo LG, Yates AP, Roberts SA, Pemberton P, Laing I. The relationships between AMH, androgens, insulin resistance and basa ovarian follicular status in non-obese subfertile women with and without polycystic ovary syndrome. Hum Reprod. 2009;24:2917–23.
Fleming R, Deshpande N, Traynor I, Yates RW. Dynamics of FSH-induced follicular growth in subfertile women: relationship with age, insulin resistance, oocyte yield and anti-Mullerian hormone. Hum Reprod. 2006;21:1436–41.
Broer SL, Mol BW, Hendriks D, Broekmans FJ. The role of anti-Mullerian hormone in prediction of outcome after IVF: comparison with the antral follicle count. Fertil Steril. 2009;91:705–14.
Elgindy EA, El-Haieg DO, El-Sebaey A. Anti-Mullerian hormone: correlation of early follicular, ovulatory and midluteal levels with ovarian response and cycle outcome in intracytoplasmic sperm injection patients. Fertil Steril. 2008;89:1670–6.
Lekamge DN, Barry M, Kolo M, Lane M, Gilchrist RB, Tremellen KP. Anti-Mullerian hormone as a predictor of IVF outcome. Reprod Biomed Online. 2007;14:602–10.
Hazout A, Bouchard P, Seifer DB, Aussage P. Serum antimullerian hormone/mullerian-inhibiting substance appears to be a more discriminatory marker of assisted reproductive technology outcome than follicle-stimulating hormone, inhibin B, or estradiol. Fertil Steril. 2004;82:1323–9.
Eldar-Geva T, Ben-Chetrit A, Spitz IM, Rabinovitz R, Markovitz E, Mimoni T, et al. Dynamic assays of inhibin B, anti-Mullerian hormone and estradiol following FSH stimulation and ovarian ultrasonography as predictors of IVF outcome. Hum Reprod. 2005;20:3178–83.
Rotterdam ESHRE/ASRM–Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term healthy risks related to polycystic ovary syndrome. Fertil Steril. 2004;82 Suppl 3:1193–7.
Muttukrishna S, McGarrigle H, Wakim R, Khadum I, Ranieri DM, Serhal P. Antral follicle count, anti-Mullerian hormone and inhibin B: predictors of ovarian response in assisted reproductive technology? Br J Obstet Gynaecol. 2005;112:1384–90.
Gnoth C, Schuring AN, Friol K, Tigges J, Mallmann P, Godehardt E. Relevance of anti-Mullerian hormone measurement in a routine IVF program. Hum Reprod. 2008;23:1359–65.
Grossman MP, Nakajima ST, Fallat ME, Siow Y. Müllerian-inhibiting substance inhibits cytochrome P450 aromatase activity in human granulosa lutein cell culture. Fertil Steril. 2008;89:1364–70.
Kaya C, Pabuccu R, Satıroglu H. Serum antimullerian hormone concentrations on day 3 of the in vitro fertilization stimulation cycle are predictive of the fertilization, implantation, and pregnancy in polycystic ovary syndrome patients undergoing assisted reproduction. Fertil Steril. 2010;94:2202–7.
Fanchin R, Schonauer LM, Righini C, Frydman N, Frydman R, Taieb J. Serum anti-Mullerian hormone dynamics during controlled ovarian hyperstimulation. Hum Reprod. 2003;18:328–32.
La Marca A, Malmusi S, Giulini S, Tamaro LF, Orvieto R, Levratti P, et al. Anti-Mullerian hormone plasma levels in spontaneous menstrual cycle and during treatment with FSH to induce ovulation. Hum Reprod. 2004;19:2738–41.
Silberstein T, MacLaughlin DT, Shai I, Trimarchi JR, Lambert-Messerlian G, Seifer DB, et al. Mullerian inhibiting substance levels at the time of HCG administration in IVF cycles predict both ovarian reserve and embryo morphology. Hum Reprod. 2006;21:159–63.
Van Der Spuy ZM, Dyer SJ. The pathogenesis of infertility and early pregnancy loss in polycystic ovary syndrome. Best Pract Res Clin Obstet Gynaecol. 2004;18:755–71.
Tesarik J. Effects of LH on oocyte yield and developmental competence. Hum Reprod. 2003;18:1358–60.
Franks S, Stark J, Hardy K. Follicle dynamics and anovulation in polycystic ovary syndrome. Hum Reprod Update. 2008;14:367–78.
Dumesic DA, Schramm RD, Peterson E, Paprocki AM, Zhou R, Abbott DH. Impaired developmental competence of oocytes in adult prenatally androgenized female rhesus monkeys undergoing gonadotropin stimulation for in vitro fertilization. J Clin Endocrinol Metab. 2002;87:1111–9.
Santos MA, Kuijk EW, Macklon NS. The impact of ovarian stimulation for IVF on the developing embryo. Reproduction. 2010;139:23–34.
Dumesic DA, Padmanabhan V, Abbott DH. Polycystic Ovary Syndrome and Oocyte Developmental Competence. Obstet Gynecol Surv. 2008;63:39–48.
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In PCOS women, high AMH levels on day 3 of the IVF stimulation cycle predict high ovarian response to gonadotrophins, but low embryo implantation rates.
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Xi, W., Gong, F. & Lu, G. Correlation of serum Anti-Müllerian hormone concentrations on day 3 of the in vitro fertilization stimulation cycle with assisted reproduction outcome in polycystic ovary syndrome patients. J Assist Reprod Genet 29, 397–402 (2012). https://doi.org/10.1007/s10815-012-9726-x
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DOI: https://doi.org/10.1007/s10815-012-9726-x