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The value of Anti-Müllerian hormone in low and extremely low ovarian reserve in relation to live birth after in vitro fertilization

活产 抗苗勒氏激素 医学 卵巢储备 卵胞浆内精子注射 体外受精 产科 逻辑回归 男科 生育率 窦卵泡 优势比 促卵泡激素 内科学 激素 胚胎移植 妇科 卵巢 内分泌学 怀孕 人类受精 控制性卵巢过度刺激 不育 卵泡期 人口 生物 环境卫生 遗传学
作者
Igna F. Reijnders,W.L.D.M. Nelen,Joanna IntHout,Antonius E. van Herwaarden,D.D.M. Braat,Kathrin Fleischer
出处
期刊:European Journal of Obstetrics & Gynecology and Reproductive Biology [Elsevier BV]
卷期号:200: 45-50 被引量:15
标识
DOI:10.1016/j.ejogrb.2016.02.007
摘要

Objective To determine the relation of Anti-Müllerian hormone (AMH) with live birth after in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) in women with (extremely) low ovarian reserve. Study design This study was a retrospective cohort study in a Dutch tertiary fertility clinic. Between January 2009 and March 2012, AMH levels were measured in infertile women when ≥36 years of age or when showing clinical signs of diminished ovarian reserve, before they underwent IVF or ICSI treatment. Ultimately, 156 women with (extremely) low ovarian reserve were included and evaluated for cumulative live birth rates. Of each woman, only one treatment cycle was analyzed, either the one in which she became pregnant or her first treatment cycle if she did not reach pregnancy. The relation between AMH and live birth was evaluated with multivariable logistic regression analysis. A ROC curve was composed to evaluate the discriminative value of AMH in relation to live birth after IVF/ICSI. Results Thirty-three out of 156 women (21.2%) gave live birth. Live birth was significantly lower in women with AMH ≤0.1 ng/ml (4/37 women; 10.8%) or AMH >0.1–0.4 ng/ml (7/42 women; 16.7%), compared to women with AMH >0.4–1.05 ng/ml (22/77 women; 28.6%), p < 0.001. Multivariable logistic regression revealed an association between the severity of low ovarian reserve and live birth (per 0.1 ng/ml increase in AMH value, Odds ratio 1.21; 95% CI 1.07–1.36). Conclusions The level of AMH is related to live birth after IVF/ICSI in women with (extremely) low ovarian reserve. The live birth rate in women with AMH >0.4 ng/ml was significantly higher than in women with AMH ≤0.4 ng/ml. AMH could serve as a tool in the pre-treatment counseling for pregnancy and live birth chances in women with (extremely) low ovarian reserve.
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