How FSH and AMH reflect probabilities of oocyte numbers in poor prognosis patients with small oocyte yields

Endocrine. 2016 Nov;54(2):476-483. doi: 10.1007/s12020-016-1068-5. Epub 2016 Aug 10.

Abstract

In poor prognosis patients undergoing in vitro fertilization, advance determinations of likely oocyte yields are especially important since oocyte numbers to large degree determine in vitro fertilization cycle outcomes. Based on baseline follicle stimulating hormone and anti-müllerian hormone levels at time of initial presentation, we here, therefore, determined at all ages the probabilities of obtaining 1-≥5 oocytes in a retrospective analysis of 1554 consecutive patients undergoing in vitro fertilization cycles at an academically affiliated private fertility center. At lowest levels (≤2.5 mIU/mL), Follicle stimulating hormone at all ages was highly predictable for ≥1 oocyte (88-96 %). Probabilities declined and diverged between ages with increasing follicle stimulating hormone, though narrowed again at high follicle stimulating hormone. Anti-Müllerian hormone demonstrated at higher levels (2.5-≥5 ng/ml) at all ages almost perfect probabilities (99-100 %). With declining anti-Müllerian hormone, age categories, however, increasingly diverged, though to lesser degree than follicle stimulating hormone. In poor prognosis patients, follicle stimulating hormone and anti-Müllerian hormone, thus, offer at different ages very specific probabilities for retrieval of 1-≥5 oocytes. Since oocyte numbers are associated with embryo numbers, and numbers of transferable embryos with live birth rates, here presented probability tables should facilitate improved prognostication of poor prognosis patients. Discrepancies in here reported probabilities between follicle stimulating hormone and anti-müllerian hormone also further define follicle stimulating hormone and anti-müllerian hormone in their respective abilities to represent functional ovarian reserve at different ages.

Keywords: Anti-Müllerian hormone (AMH); Embryo numbers; Follicle stimulating hormone (FSH); In vitro fertilization (IVF); Oocyte numbers.

MeSH terms

  • Adult
  • Anti-Mullerian Hormone / blood*
  • Cell Count
  • Female
  • Fertilization in Vitro
  • Follicle Stimulating Hormone / blood*
  • Humans
  • Infertility, Female / blood*
  • Infertility, Female / therapy
  • Oocyte Retrieval*
  • Oocytes / cytology*
  • Ovulation Induction
  • Prognosis
  • Retrospective Studies

Substances

  • Anti-Mullerian Hormone
  • Follicle Stimulating Hormone