Very low anti-müllerian hormone concentrations are not an independent predictor of embryo quality and pregnancy rate

Abstract

Research question: Is anti-Müllerian hormone (AMH) serum concentration a useful tool to predict the outcome of assisted reproductive treatment?

Design: Retrospective cohort study involving 2971 patients who underwent 5570 IVF cycles. Patients were classified into six groups according to their AMH levels and analysed for associations with reproductive outcome. Several parameters of ovarian response and clinical outcome were compared between groups.

Results: Cancellation rate and clinical pregnancy rate varied by AMH group, with highest cancellation rates (32.8%, P = 0.021) and lowest clinical pregnancy rates (9.8%, P < 0.001) in the group with lowest AMH. When these patients achieved embryo transfer, the implantation rate (30.5%) did not significantly differ from the other groups, and retained a low, but reasonable, clinical pregnancy rate per transfer (45.9%). When this group was classified into three female age groups, the clinical pregnancy rate was found to be significantly higher in the patients younger than 37 years (58.1%) compared with patients aged between 37 and 39 years (48.9%) and those aged over 39 years (27%, P < 0.001).

Conclusions: Although significant differences in pregnancy rates were observed among the different AMH groups, even in the lowest AMH level group, the probability of achieving pregnancy was reasonable, especially if the patient's age is not very advanced.

Keywords: AMH; ART outcomes; Low AMH; Ovarian reserve; Prognostic factor; Ultralow AMH.