Premium
Using anti‐Müllerian hormone to identify a good prognosis group in women of advanced reproductive age
Author(s) -
FRIDÉN Barbro,
SJÖBLOM Peter,
MENEZES Judith
Publication year - 2011
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.2011.01374.x
Subject(s) - anti müllerian hormone , ovarian reserve , intracytoplasmic sperm injection , gynecology , in vitro fertilisation , medicine , antral follicle , advanced maternal age , embryo transfer , live birth , pregnancy , andrology , obstetrics , hormone , infertility , biology , fetus , genetics
Background: The probability of pregnancy after in vitro fertilisation (IVF) declines with age in parallel with a reduction in the ovarian reserve. However, there is considerable variation in the ovarian reserve in women of advanced reproductive age; so to give such women accurate advice about the prospects of treatment success, factors other than age must be considered. Anti‐Müllerian hormone (AMH) has been shown to be a good indicator of ovarian reserve, and its utility is explored in this paper. Aims: To determine the utility of AMH serum levels for prediction of ovarian response to gonadotropin stimulation and outcome in IVF in women of advanced reproductive age. Methods: The material consists of 127 women with a median age of 42 years (range 39–46) having had their first cycle of IVF/intracytoplasmic sperm injection (ICSI) treatment from November 2006 to December 2008. During this period, a total of 772 oocyte retrievals and 715 embryo transfers were performed at the clinic (median age 36.4 years). AMH was analysed with the Beckman Coulter DSL ELISA. Agonist and antagonist protocols were used and monitored by ultrasound and oestradiol; embryo transfer was performed on day 2, 3 or 5 of culture. Results: The lower the AMH, the higher the risk of cycle cancellation, low oocyte yield and treatment failure. Women with a serum AMH above 8.6 pmol/L had a good chance of achieving live birth after IVF/ICSI treatment. Conclusions: Anti‐Müllerian hormone is useful for identifying a good prognosis group in women of advanced reproductive age.