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