Anti-mullerian hormone level is a reliable predictor for cycle cancellation in ICSI

Objectives: To evaluate serum AMH level as a predictor of ovarian response to stimulation and outcome of ICSI.Design of the study: A prospective clinical study.Setting and time: Mansoura general hospital and Benha university hospital, during the period from October 2007 to May 2008.Patients and methods: Sixty women aged 20–39years scheduled for ICSI were included in the study. Cases of polycystic ovaries were excluded. Serum AMH level was determined using an enzyme-amplified two-site immunoassay. The stimulation protocol used was the short protocol.Outcome measures: Correlation between the AMH level and the number of retrieved MII oocytes; the AMH level in cancelled and completed cycles and in non-pregnant and pregnant and its value in prediction of these variables.Results: There was a highly significant positive correlation between AMH level and number of retrieved MII oocytes (R2=0.33, P<0.001). Levels were highly significant lower in cancelled than in completed cycles (P=0.0143), and non-significant lower in non-pregnant than in pregnant (P=0.0519). The AMH level was a fair test for discrimination between cancelled and completed cycles (ROC–AUC 0.747, 95% CI 0.618–0.850), but it was a poor test for discrimination between non-pregnant and pregnant (ROC–AUC 0.659, 95% CI 0.526–0.777). Cutoff level AMH of 0.9ng/ml had the best sensitivity (80%) and specificity (64%) in predicting poor response and cycle cancellation (P<0.01), but it was of no value in predicting non-pregnancy.Conclusions: AMH is a reliable marker for ovarian response to stimulation as regards the number of retrieved MII oocytes and cancelled or completed cycles, but not for the success of ICSI as regards non-pregnancy or pregnancy