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Antimüllerian hormone linked to live-birth rates after IVF
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Researchers from Sweden now suggest that antimüllerian hormone levels are linked to live-birth rates after in vitro fertilization–intracytoplasmic sperm injection. Even after adjustments for age and egg production, these data further suggest that antimüllerian hormone levels could be a predictor of pregnancy and live birth.
“For women who are struggling to get pregnant, a high [antimüllerian hormone] level should be very reassuring,” study researcher Thomas Brodin, MD, of Uppsala University in Sweden, said in a press release. “High levels of this hormone mean there is a greater chance they have plenty of healthy eggs remaining to support a pregnancy.”
According to the press release, Brodin and colleagues discovered that women with high levels of antimüllerian hormone were 2.5 times more likely to have a successful in vitro fertilization (IVF) cycle compared with women of similar age with low levels of the hormone.
The prospective study consisted of 892 consecutive women who underwent 1,230 IVF-intracytoplasmic sperm injection cycles between April 2008 and June 2011 at a university-affiliated private infertility center. Their antimüllerian hormone levels were adjusted for several treatments and age, and they were further analyzed based on the treatment outcome, researchers wrote.
According to data, antimüllerian hormone levels were log-normally distributed with a mean standard deviation (SD) of 2.3 (2.5) ng/mL. Researchers reported live-birth rates per started cycle increased log-linearly from 10.7% (95% CI, 7.2-14.1) for antimüllerian hormone levels <0.84 ng/mL (25th percentile) compared with 30.8% (95% CI, 25.7-36) for antimüllerian hormone levels >2.94 ng/mL (75th percentile). This trend (P<.0001) was greater in women with polycystic ovaries, researchers wrote.
“Our data suggests women who have polycystic ovaries are likely to be good candidates for IVF,” Brodin said. “Along with high [antimüllerian hormone] levels, this group tends to have a significant supply of eggs remaining in the ovaries.”
These findings were significant after adjustments for age and oocyte yield, the researchers wrote. They conclude that antimüllerian hormone levels were positively linked to ovarian response variables and embryo scores.
Disclosure: The researchers report no relevant financial disclosures.
Perspective
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Hugh S. Taylor, MD
Antimüllerian hormone (AMH) is produced directly by the granulose cells of the growing follicle, suggesting that it may be a superior marker of ovarian reserve than other indirect measurements such as follicle stimulating hormone (FSH). The authors used a group of patients undergoing IVF to determine if AMH predicts pregnancy. In this study, there were few exclusion criteria and subjects with polycystic ovary syndrome were included. AMH was highly correlated with a successful pregnancy even after adjusting for age. This relationship also applied to patients with PCOS. This study adds to the weight of evidence favoring the use of AMH over FSH or other serum markers of ovarian reserve. AMH is also less cycle dependent and therefore a convenient marker. AMH should replace FSH as the preferred serum "fertility" test, although panels of markers may prove even more predictive.
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