Anti-Müllerian Hormone and Follicle-Stimulating Hormone Are Poor Independent Predictors of Live Birth After Assisted Reproductive Technology

Overview

Journal Reprod Sci

Publisher Springer

Specialty Reproductive Medicine

Date 2022 Oct 4

PMID 36194358

Authors

Dana R Siegel

Laura Grau

Mary Sammel

Liesl Nel-Themaaat

Nanette Santoro

Alex J Polotsky

Affiliations

Soon will be listed here.

Abstract

To query if anti-Müllerian hormone (AMH) and/or follicle-stimulating hormone (FSH) predict live birth at the University of Colorado Advanced Reproductive Medicine (CU ARM). This was a retrospective analysis using the Society for Assisted Reproductive Technology (SART) Clinic Outcome Reporting System database at CU ARM from 2017 to 2019 to identify the pregnancy outcomes of the initial fresh or frozen embryo transfer (FET) and their corresponding AMH and FSH. Fisher's exact tests were used to identify differences in pregnancy outcome by age group, and area under the receiver operator characteristic curves was used to quantify live birth prediction. A total of 1083 records from 557 patients were reviewed. After only including the first autologous transfer, 270 cycles were analyzed. Overall live birth (L/B) rate was 58.15% (157/270), which declined with increasing age group (p ≤ 0.01). Although AMH significantly decreased with increasing age (p < 0.001), it was not associated with pregnancy outcome (3.54 ng/mL vs. 3.41 ng/mL, p = 0.56); this relationship was unchanged after controlling for age in logistic regression models (p = 0.52). FSH was also not significantly related to pregnancy outcome (7.00 IU/L vs 6.00 IU/L, p = 0.15), and this relationship did not change after controlling for age (p = 0.61). Using AUC, the only variable predictive of live birth was age (p = 0.002). AMH and FSH are not associated with the probability of live birth. Only age was significantly associated with live birth in this series. AMH and FSH should therefore be used cautiously when counseling patients about ART outcomes.

References

van Rooij I, Broekmans F, Scheffer G, Looman C, Habbema J, de Jong F . Serum antimullerian hormone levels best reflect the reproductive decline with age in normal women with proven fertility: a longitudinal study. Fertil Steril. 2005; 83(4):979-87. DOI: 10.1016/j.fertnstert.2004.11.029. View

La Marca A, Stabile G, Artenisio A, Volpe A . Serum anti-Mullerian hormone throughout the human menstrual cycle. Hum Reprod. 2006; 21(12):3103-7. DOI: 10.1093/humrep/del291. View

Dewailly D, Andersen C, Balen A, Broekmans F, Dilaver N, Fanchin R . The physiology and clinical utility of anti-Mullerian hormone in women. Hum Reprod Update. 2014; 20(3):370-85. DOI: 10.1093/humupd/dmt062. View

Seifer D, MacLaughlin D, Christian B, Feng B, Shelden R . Early follicular serum müllerian-inhibiting substance levels are associated with ovarian response during assisted reproductive technology cycles. Fertil Steril. 2002; 77(3):468-71. DOI: 10.1016/s0015-0282(01)03201-0. View

La Marca A, Sighinolfi G, Radi D, Argento C, Baraldi E, Artenisio A . Anti-Mullerian hormone (AMH) as a predictive marker in assisted reproductive technology (ART). Hum Reprod Update. 2009; 16(2):113-30. DOI: 10.1093/humupd/dmp036. View

Broer S, Dolleman M, Opmeer B, Fauser B, Mol B, Broekmans F . AMH and AFC as predictors of excessive response in controlled ovarian hyperstimulation: a meta-analysis. Hum Reprod Update. 2010; 17(1):46-54. DOI: 10.1093/humupd/dmq034. View

Smeenk J, Sweep F, Zielhuis G, Kremer J, Thomas C, Braat D . Antimüllerian hormone predicts ovarian responsiveness, but not embryo quality or pregnancy, after in vitro fertilization or intracyoplasmic sperm injection. Fertil Steril. 2006; 87(1):223-6. DOI: 10.1016/j.fertnstert.2006.06.019. View

Wang X, Jin L, Mao Y, Shi J, Huang R, Jiang Y . Evaluation of Ovarian Reserve Tests and Age in the Prediction of Poor Ovarian Response to Controlled Ovarian Stimulation-A Real-World Data Analysis of 89,002 Patients. Front Endocrinol (Lausanne). 2021; 12:702061. PMC: 8435745. DOI: 10.3389/fendo.2021.702061. View

Irani M, Canon C, Robles A, Maddy B, Gunnala V, Qin X . No effect of ovarian stimulation and oocyte yield on euploidy and live birth rates: an analysis of 12 298 trophectoderm biopsies. Hum Reprod. 2020; 35(5):1082-1089. DOI: 10.1093/humrep/deaa028. View

10.

Jain T, Soules M, Collins J . Comparison of basal follicle-stimulating hormone versus the clomiphene citrate challenge test for ovarian reserve screening. Fertil Steril. 2004; 82(1):180-5. DOI: 10.1016/j.fertnstert.2003.11.045. View

11.

Martin J, Nisker J, Tummon I, Daniel S, Auckland J, Feyles V . Future in vitro fertilization pregnancy potential of women with variably elevated day 3 follicle-stimulating hormone levels. Fertil Steril. 1996; 65(6):1238-40. DOI: 10.1016/s0015-0282(16)58347-2. View

12.

Esposito M, Coutifaris C, Barnhart K . A moderately elevated day 3 FSH concentration has limited predictive value, especially in younger women. Hum Reprod. 2002; 17(1):118-23. DOI: 10.1093/humrep/17.1.118. View

13.

Broekmans F, Kwee J, Hendriks D, Mol B, Lambalk C . A systematic review of tests predicting ovarian reserve and IVF outcome. Hum Reprod Update. 2006; 12(6):685-718. DOI: 10.1093/humupd/dml034. View

14.

Balachandren N, Salman M, Diu N, Schwab S, Rajah K, Mavrelos D . Ovarian reserve as a predictor of cumulative live birth. Eur J Obstet Gynecol Reprod Biol. 2020; 252:273-277. DOI: 10.1016/j.ejogrb.2020.06.063. View