Definition by FSH, AMH and embryo numbers of good-, intermediate- and poor-prognosis patients suggests previously unknown IVF outcome-determining factor associated with AMH.

In IVF patients, mid-range anti-Müllerian hormone (AMH) levels were associated with the highest IVF pregnancy rates, while the lower and higher AMH levels predicted poorer outcomes.

Published in Journal of Translational Medicine

Background
Though outcome models have been proposed previously, it is unknown whether cutoffs in clinical pregnancy and live birth rates at all ages are able to classify in vitro fertilization (IVF) patients into good-, intermediate- and poor prognosis.

Methods
We here in 3 infertile patient cohorts, involving 1247, 1514 and 632 women, built logistic regression models based on 3 functional ovarian reserve (FOR) parameters, including (1) number of good quality embryos, (2) follicle stimulating hormone (FSH, mIU/mL) and (3) anti-Müllerian hormone (AMH, ng/mL), determining whether clinical pregnancy and live birth rates can discriminate between good, intermediate and poor prognosis patients.

Results
All models, indeed, allowed at all ages for separation by prognosis, though cut offs changed with age. In the embryo model, increasing embryo production resulted in linear improvement of IVF outcomes despite transfer of similar embryo numbers; in the FSH model outcomes and FSH levels related inversely, while the association of AMH followed a bell-shaped polynomial pattern, demonstrating “best” outcomes at mid-ranges. All 3 models demonstrated increasingly poor outcomes with advancing ages, though “best” AMH even above age 43 was still associated with unexpectedly good pregnancy and delivery outcomes. Excessively high AMH, in contrast, was at all ages associated with spiking miscarriage rates.

Conclusions
At varying peripheral serum concentrations, AMH, thus, demonstrates hitherto unknown and contradictory effects on IVF outcomes, deserving at different concentrations investigation as a potential therapeutic agent, with pregnancy-supporting and pregnancy-interrupting properties.

Citation Page #: 10;14(1):172
Journal: Journal of Translational Medicine
Author Publication: Gleicher N, Kushnir VA, Sen A, Darmon SK, Weghofer A, Wu YG, Wang Q, Zhang L, Albertini DF, Barad DH.
Publication Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4901433/
Date: 2016