Impact of antimullerian hormone assays on the outcomes of in vitro fertilization a prospective controlled study

Capsule:
The AMH assays reduced the cancellation rate after ovarian stimulation and helped some patients not to begin IVF stimulation because of their low AMH level.

Authors:
Mohamed Aboulghar, M.D., Walid Saber, M.D., Yahia Amin, M.D., Mona Aboulghar, M.D., Gamal Serour, F.R.C.O.G., Ragaa Mansour, M.D., Ph.D.

Volume 101, Issue 1, Pages 134-137, January 2014

Abstract:

Objective:
To assess the value of routine antimüllerian hormone (AMH) assays in patients considered high risk for cancellation.

Design:
Prospective controlled study.

Setting:
A private IVF center, Cairo, Egypt.

Patient(s):
In total 4,917 patients received counseling before starting IVF/intracytoplasmic sperm injection (ICSI). They were comprised of group A1 (n = 1,335), who were considered to be at risk for cancellation after ovarian stimulation, and group A2 (n = 3,582), who were considered low risk for cancellation. A control group, B (n = 4,639), included group B1 (n = 1,248) and group B2 (n = 3,391) based on the same criteria as groups A1 and A2.

Intervention(s):
An AMH assessment was performed for group A1. All of the patients were stimulated using the long GnRH agonist protocol. Patients with low AMH levels received the flare-up protocol.

Main Outcome Measure(s):
The cancellation of IVF/ICSI cycles before or after stimulation, as well as the pregnancy rates (PR) in relation to AMH levels.

Result(s):
The group A1 patients (6.4%) did not start IVF due to low AMH, and some (6.6%) had their cycles canceled due to poor responses, compared with 2.6% in group A2 and 13.2% in group B1. The clinical PR was 42% in patients with normal AMH and 20% in patients with low AMH. The differences among these three groups were highly significant.

Conclusion(s):
The AMH assays reduced the cancellations, cost, and stress experienced by couples.

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