EFFECTS OF INCREASING ANTIMULLERIAN HORMONE LEVEL ON IN-VITRO FERTILIZATION AND FROZEN EMBRYO TRANSFER OUTCOMES

Anti-mullerian hormone (AMH) is a reliable predictor of ovarian response in IVF. However, its role as a prognostic marker of pregnancy outcome is conflicting. While high AMH corresponds to improved oocyte yield, AMH serum concentration of 5 ng/mL was associated with decreased odds of life birth following fresh transfer [1]. The outcome following frozen embryo transfer (FET) remains unexplored. Therefore, the objective if this study was to evaluate the association between high AMH and live birth in autologous IVF cycle followed by at least one FET. Retrospective analysis of the Shady Grove database from January 2010 to December 2020. All fresh autologous IVF cycles with available AMH value performed in last 6 months before IVF (n=29,434), were included. Based on AMH serum concentration, cycles were stratified into 3 groups; Low (<1 ng/mL), intermediate (1.0-4.9 ng/mL), and high (≥5 ng/mL). Cycle characteristics were compared compared between the individual groups using 3-way ANOVA. Pregnancy outcomes such as live birth rate (LBR), and miscarriage rates were compared using chi-squared test. Women in the high AMH group were younger (33.1± 4.1) and had higher antral follicle count (26.5±5.3) than the intermediate and low AMH groups (<0.001). High AMH patients required lower gonadotropin dose (2323.9±1117.2 IU) than other groups (p<0.001) however average stimulation day was 12 in all groups. In the high AMH group, 32.6% of patients had PCOS. The number of mature oocytes was significantly higher in the high AMH group as compared to intermediate and low AMH groups (17 vs.10 vs. 4, p< 0.001). Following fresh embryo transfer, LBR was significantly higher in the high AMH group (46%) as compared to intermediate AMH (40.4%) and low AMH (27%); p < 0.01. When FET cycle outcomes were compared, LBR was significantly higher in the high (46.7%) and intermediate (47.4%) AMH group as compared to low AMH group (43.7%), p< 0.001. There was no difference in LBR between the high and intermediate group (p=0.365). There was no difference noted in miscarriage rate between low (12.3%), intermediate (12.1%) and high (12.4%) AMH group (p=0.807). High serum AMH levels 5 ng/mL are not associated with lower LBR per transfer either following fresh or frozen embryo transfer.