Predictability of consecutive measurements of serum Anti-Mullerian Hormone (AMH) during In Vitro Fertilization (IVF)

Authors

  • Saman Hussein Noori University of Sulaimani / College of Medicine / Department of Biochemistry

Abstract

Background : In recent years, many studies had been carried out on the basal AMH level and its association with controlled ovarian hyperstimulation (COH) outcome. Only a few studies have been conducted on the correlation between COH outcomes and AMH levels measured on different stimulation days and these studies did not show a comparison between different measurement timings over the entire period of the COH cycle.

Objectives: the current study aim is to assess the predictive values of basal and consecutive serum AMH levels during COH cycle.

Methods and Results: One hundred women were involved in this study, scheduled for IVF program in Dwarozh Fertility Center in Sulaimanyiah , between December 2015 until January 2017, blood samples were collected for measurement of AMH, Estradiol, and FSH on day 2 of menstrual cycle, and the subsequent samples on day 4,6,8 and 10 were taking after the stimulation of ovaries with gonadotrophin. All hormones being analyzed by using electrochemiluminescence methods (Cobas 411 by Roche) as a single batch, each patient was given a unique numerical identifier, which issued in data analysis. P values <0.05 were considered significant.

Results: the patients' characteristics , basal serum estradiol (E2), FSH and AMH levels at day 2 of cycle and  subsequent days after stimulation . As expected significant differences were observed for total dosage of FSH, peak E2 levels and duration of stimulation between short and long GnRH agonist groups. The ROC curve was used to assess the  AMH values in different days (day 2, 4, 6, 8, and 10) for prediction of IVF outcomes (implantation, abortion, preganancy and live birth). All the days showed significant area under the curve (AUC) (p<0.05). However, when all the ROC curve were comapred to each others there were no significance differences bwteeen them (p>0.05)

Conclusions:  The present study concluded that measurement of serum AMH at any time after stimulation still predictive of the IVF outcomes which will reinforce the already known value of AMH in clinical practice.

References

Dondik Y, Virji N, Butler TS, Gaskins JT, Pagidas K, Sung L. The Value of Anti-Mullerian Hormone in Predicting Clinical Pregnancy After Intrauterine Insemination. J Obstet Gynaecol Can. 2017 Jun 21.

Meczekalski B, Czyzyk A, Kunicki M, Podfigurna-Stopa A, Plociennik L, Jakiel G, et al. Fertility in women of late reproductive age: the role of serum anti-Mullerian hormone (AMH) levels in its assessment. J Endocrinol Invest. [Review]. 2016 Nov;39(11):1259-65.

Seifer DB, MacLaughlin DT, Christian BP, Feng B, Shelden RM. Early follicular serum mullerian-inhibiting substance levels are associated with ovarian response during assisted reproductive technology cycles. Fertil Steril. [Comparative Study]. 2002 Mar;77(3):468-71.

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 Dec;17(12):3065-71.

Muttukrishna S, Suharjono H, McGarrigle H, Sathanandan M. Inhibin B and anti-Mullerian hormone: markers of ovarian response in IVF/ICSI patients? Bjog. 2004 Nov;111(11):1248-53.

Hazout A, Bouchard P, Seifer DB, Aussage P, Junca AM, Cohen-Bacrie 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. [Comparative Study]. 2004 Nov;82(5):1323-9.

Mantzavinos SD, Vlahos NP, Rizos D, Botsis D, Sergentanis TN, Deligeoroglou E, et al. Correlation of serum anti-Mullerian hormone levels with positive in vitro fertilization outcome using a short agonist protocol. Hormones (Athens). 2017 Apr;16(2):161-70.

La Marca A, Giulini S, Tirelli A, Bertucci E, Marsella T, Xella S, et al. Anti-Mullerian hormone measurement on any day of the menstrual cycle strongly predicts ovarian response in assisted reproductive technology. Hum Reprod. 2007 Mar;22(3):766-71.

Knez J, Kovacic B, Medved M, Vlaisavljevic V. What is the value of anti-Mullerian hormone in predicting the response to ovarian stimulation with GnRH agonist and antagonist protocols? Reprod Biol Endocrinol. [Research Support, Non-U.S. Gov't]. 2015 Jun 10;13:58.

La Marca A, Stabile G, Artenisio AC, Volpe A. Serum anti-Mullerian hormone throughout the human menstrual cycle. Hum Reprod. 2006 Dec;21(12):3103-7.

Amanvermez R, Tosun M. An Update on Ovarian Aging and Ovarian Reserve Tests. Int J Fertil Steril. [Review]. 2016 Jan-Mar;9(4):411-5.

Mutlu MF, Erdem A. Evaluation of ovarian reserve in infertile patients. J Turk Ger Gynecol Assoc. 2012;13(3):196-203.

Jirge PR. Ovarian reserve tests. J Hum Reprod Sci. 2011 Sep;4(3):108-13.

Ragni G, Chiaffarino F, Scarduelli C, Bonetti S, Nicolosi AE, Arnoldi M, et al. The clomiphene citrate challenge test (CCCT) in women with elevated basal FSH: biological significance and predictive value. Eur J Obstet Gynecol Reprod Biol. [Evaluation Studies]. 2008 Nov;141(1):44-8.

Ravhon A, Lavery S, Michael S, Donaldson M, Margara R, Trew G, et al. Dynamic assays of inhibin B and oestradiol following buserelin acetate administration as predictors of ovarian response in IVF. Hum Reprod. 2000 Nov;15(11):2297-301.

Fanchin R, Schonauer LM, Righini C, Frydman N, Frydman R, Taieb J. Serum anti-Mullerian hormone dynamics during controlled ovarian hyperstimulation. Hum Reprod. 2003 Feb;18(2):328-32.

Eldar-Geva T, Ben-Chetrit A, Spitz IM, Rabinowitz R, Markowitz 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 Nov;20(11):3178-83.

Catteau-Jonard S, Pigny P, Reyss AC, Decanter C, Poncelet E, Dewailly D. Changes in serum anti-mullerian hormone level during low-dose recombinant follicular-stimulating hormone therapy for anovulation in polycystic ovary syndrome. J Clin Endocrinol Metab. [Research Support, Non-U.S. Gov't]. 2007 Nov;92(11):4138-43.

Fanchin R, Mendez Lozano DH, Louafi N, Achour-Frydman N, Frydman R, Taieb J. Dynamics of serum anti-Mullerian hormone levels during the luteal phase of controlled ovarian hyperstimulation. Hum Reprod. 2005 Mar;20(3):747-51.

Weintraub A, Margalioth EJ, Chetrit AB, Gal M, Goldberg D, Alerhand S, et al. The dynamics of serum anti-Mullerian-hormone levels during controlled ovarian hyperstimulation with GnRH-antagonist short protocol in polycystic ovary syndrome and low responders. Eur J Obstet Gynecol Reprod Biol. 2014 May;176:163-7.

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 Jun;89(6):1670-6.

Penarrubia J, Fabregues F, Manau D, Creus M, Casals G, Casamitjana R, et al. Basal and stimulation day 5 anti-Mullerian hormone serum concentrations as predictors of ovarian response and

pregnancy in assisted reproductive technology cycles stimulated with gonadotropin-releasing hormone agonist--gonadotropin treatment. Hum Reprod. [Clinical Trial Randomized Controlled Trial Research Support, Non-U.S. Gov't]. 2005 Apr;20(4):915-22.

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 Jan;21(1):159-63.

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Published

2019-04-29

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