Skip to main content
Top
Published in: Journal of Assisted Reproduction and Genetics 5/2016

01-05-2016 | Assisted Reproduction Technologies

IVF results in patients with very low serum AMH are significantly affected by chronological age

Authors: Alberto Revelli, Valentina Biasoni, Gianluca Gennarelli, Stefano Canosa, Paola Dalmasso, Chiara Benedetto

Published in: Journal of Assisted Reproduction and Genetics | Issue 5/2016

Login to get access

Abstract

Purpose

The aims of this study were to assess the outcome of in vitro fertilization (IVF) in women with very low circulating anti-müllerian hormone (AMH) and to investigate factors affecting their probability of pregnancy.

Methods

The outcome of 448 IVF cycles in 361 women with circulating AMH <0.5 ng/ml was retrospectively analyzed.

Results

Cycle cancellation rate was 14.5 %; patients whose cycle was cancelled had significantly lower AMH than women who reached oocyte pickup (OPU). Among those who reached OPU, age significantly affected the success rate: despite comparable AMH levels, patients below 35 years obtained significantly more oocytes and a better clinical pregnancy rate (CPR)/OPU than patients aged 35–39 or 40–43 (31 % vs. 23.2 % vs. 10.2 %, respectively; p = 0.001). Differently, comparable IVF results were observed stratifying patients for AMH levels in the range 0.14–0.49 ng/ml. Multivariable logistic regression analysis confirmed that the probability of pregnancy was significantly affected by age, but not by small differences in AMH level.

Conclusions

Women with very low (<0.5 ng/ml) AMH levels undergoing IVF still have reasonable chances of achieving a pregnancy, but their prognosis is significantly affected by chronological age. Very low AMH levels are associated with a relevant risk of cycle cancellation but should not be considered a reason to exclude a couple from IVF.
Literature
1.
go back to reference Broekmans FJ, Knauff EA, te Velde ER, Macklon NS, Fauser BC. Female reproductive ageing: current knowledge and future trends. Trends Endocrinol Metab. 2007;18:58–65.CrossRefPubMed Broekmans FJ, Knauff EA, te Velde ER, Macklon NS, Fauser BC. Female reproductive ageing: current knowledge and future trends. Trends Endocrinol Metab. 2007;18:58–65.CrossRefPubMed
2.
go back to reference Steiner AZ. Clinical implications of ovarian reserve testing. Obstet Gynecol Surv. 2009;64:120–8.CrossRefPubMed Steiner AZ. Clinical implications of ovarian reserve testing. Obstet Gynecol Surv. 2009;64:120–8.CrossRefPubMed
3.
go back to reference Broekmans FJ, Kwee J, Hendriks DJ, Mol BW, Lambalk CB. A systematic review of tests predicting ovarian reserve and IVF outcome. Hum Reprod Update. 2006;12:685–718.CrossRefPubMed Broekmans FJ, Kwee J, Hendriks DJ, Mol BW, Lambalk CB. A systematic review of tests predicting ovarian reserve and IVF outcome. Hum Reprod Update. 2006;12:685–718.CrossRefPubMed
4.
go back to reference Dewailly D, Andersen CY, Balen A, Broekmans F, Dilaver N, Fanchin R, et al. The physiology and clinical utility of anti-mullerian hormone in women. Hum Reprod Update. 2014;20:370–85.CrossRefPubMed Dewailly D, Andersen CY, Balen A, Broekmans F, Dilaver N, Fanchin R, et al. The physiology and clinical utility of anti-mullerian hormone in women. Hum Reprod Update. 2014;20:370–85.CrossRefPubMed
5.
go back to reference La Marca A, Giulini S, Tirelli A, Bertucci E, Marsella T, Xella S, et al. Anti-müllerian hormone measurement on any day of the menstrual cycle strongly predicts ovarian response in assisted reproductive technology. Hum Reprod. 2007;22:766–71.CrossRefPubMed La Marca A, Giulini S, Tirelli A, Bertucci E, Marsella T, Xella S, et al. Anti-müllerian hormone measurement on any day of the menstrual cycle strongly predicts ovarian response in assisted reproductive technology. Hum Reprod. 2007;22:766–71.CrossRefPubMed
6.
go back to reference Nelson SM, Yates RW, Fleming R. Serum anti-müllerian hormone and FSH: prediction of live birth and extremes of response in stimulated cycles—implications for individualization of therapy. Hum Reprod. 2007;22:2414–21.CrossRefPubMed Nelson SM, Yates RW, Fleming R. Serum anti-müllerian hormone and FSH: prediction of live birth and extremes of response in stimulated cycles—implications for individualization of therapy. Hum Reprod. 2007;22:2414–21.CrossRefPubMed
7.
go back to reference Muttukrishna S, Suharjono H, McGarrigle H, Sathanandan M. Inhibin B and anti-mullerian hormone: markers of ovarian response in IVF/ICSI patients? Bjog. 2004;111:1248–53.CrossRefPubMed Muttukrishna S, Suharjono H, McGarrigle H, Sathanandan M. Inhibin B and anti-mullerian hormone: markers of ovarian response in IVF/ICSI patients? Bjog. 2004;111:1248–53.CrossRefPubMed
8.
go back to reference Lekamge DN, Barry M, Kolo M, Lane M, Gilchrist RB, Tremellen KP. Anti-müllerian hormone as a predictor of IVF outcome. Reprod Biomed Online. 2007;14:602–10.CrossRefPubMed Lekamge DN, Barry M, Kolo M, Lane M, Gilchrist RB, Tremellen KP. Anti-müllerian hormone as a predictor of IVF outcome. Reprod Biomed Online. 2007;14:602–10.CrossRefPubMed
9.
go back to reference Koshy AK, Gudi A, Shah A, Bhide P, Timms P, Homburg R. Pregnancy prognosis in women with anti-müllerian hormone below the tenth percentile. Gynecol Endocrinol. 2013;29:662–5.CrossRefPubMed Koshy AK, Gudi A, Shah A, Bhide P, Timms P, Homburg R. Pregnancy prognosis in women with anti-müllerian hormone below the tenth percentile. Gynecol Endocrinol. 2013;29:662–5.CrossRefPubMed
10.
go back to reference Nelson SM, Yates RW, Lyall H, Jamieson M, Traynor I, Gaudoin M, et al. Anti-müllerian hormone-based approach to controlled ovarian stimulation for assisted conception. Hum Reprod. 2009;24:867–75.CrossRefPubMed Nelson SM, Yates RW, Lyall H, Jamieson M, Traynor I, Gaudoin M, et al. Anti-müllerian hormone-based approach to controlled ovarian stimulation for assisted conception. Hum Reprod. 2009;24:867–75.CrossRefPubMed
11.
go back to reference Merhi Z, Zapantis A, Berger DS, Jindal SK. Determining an anti-mullerian hormone cutoff level to predict clinical pregnancy following in vitro fertilization in women with severely diminished ovarian reserve. J Assist Reprod Genet. 2013;30:1361–5.CrossRefPubMedPubMedCentral Merhi Z, Zapantis A, Berger DS, Jindal SK. Determining an anti-mullerian hormone cutoff level to predict clinical pregnancy following in vitro fertilization in women with severely diminished ovarian reserve. J Assist Reprod Genet. 2013;30:1361–5.CrossRefPubMedPubMedCentral
12.
go back to reference Tocci A, Ferrero S, Iacobelli M, Greco E. Negligible serum anti-mullerian hormone: pregnancy and birth after a 1-month course of an oral contraceptive, ovarian hyperstimulation, and intracytoplasmic sperm injection. Fertil Steril. 2009;92:395 e399–12.CrossRef Tocci A, Ferrero S, Iacobelli M, Greco E. Negligible serum anti-mullerian hormone: pregnancy and birth after a 1-month course of an oral contraceptive, ovarian hyperstimulation, and intracytoplasmic sperm injection. Fertil Steril. 2009;92:395 e399–12.CrossRef
13.
go back to reference Weghofer A, Dietrich W, Barad DH, Gleicher N. Live birth chances in women with extremely low-serum anti-mullerian hormone levels. Hum Reprod. 2011;26:1905–9.CrossRefPubMed Weghofer A, Dietrich W, Barad DH, Gleicher N. Live birth chances in women with extremely low-serum anti-mullerian hormone levels. Hum Reprod. 2011;26:1905–9.CrossRefPubMed
14.
go back to reference Fraisse T, Ibecheole V, Streuli I, Bischof P, de Ziegler D. Undetectable serum anti-müllerian hormone levels and occurrence of ongoing pregnancy. Fertil Steril. 2008;89:723 e729–711.CrossRef Fraisse T, Ibecheole V, Streuli I, Bischof P, de Ziegler D. Undetectable serum anti-müllerian hormone levels and occurrence of ongoing pregnancy. Fertil Steril. 2008;89:723 e729–711.CrossRef
15.
go back to reference Tokura Y, Yoshino O, Ogura-Nose S, Motoyama H, Harada M, Osuga Y, et al. The significance of serum anti-müllerian hormone (AMH) levels in patients over age 40 in first IVF treatment. J Assist Reprod Genet. 2013;30:821–5.CrossRefPubMedPubMedCentral Tokura Y, Yoshino O, Ogura-Nose S, Motoyama H, Harada M, Osuga Y, et al. The significance of serum anti-müllerian hormone (AMH) levels in patients over age 40 in first IVF treatment. J Assist Reprod Genet. 2013;30:821–5.CrossRefPubMedPubMedCentral
16.
go back to reference Holte J, Berglund L, Milton K, Garello C, Gennarelli G, Revelli A, et al. Construction of an evidence-based integrated morphology cleavage embryo score for implantation potential of embryos scored and transferred on day 2 after oocyte retrieval. Hum Reprod. 2007;22:548–57.CrossRefPubMed Holte J, Berglund L, Milton K, Garello C, Gennarelli G, Revelli A, et al. Construction of an evidence-based integrated morphology cleavage embryo score for implantation potential of embryos scored and transferred on day 2 after oocyte retrieval. Hum Reprod. 2007;22:548–57.CrossRefPubMed
17.
go back to reference Marinakis G, Nikolaou D. What is the role of assisted reproduction technology in the management of age-related infertility? Hum Fertil (Camb). 2011;14:8–15.CrossRef Marinakis G, Nikolaou D. What is the role of assisted reproduction technology in the management of age-related infertility? Hum Fertil (Camb). 2011;14:8–15.CrossRef
18.
go back to reference La Marca A, Sunkara SK. Individualization of controlled ovarian stimulation in IVF using ovarian reserve markers: from theory to practice. Hum Reprod Update. 2014;20:124–40.CrossRefPubMed La Marca A, Sunkara SK. Individualization of controlled ovarian stimulation in IVF using ovarian reserve markers: from theory to practice. Hum Reprod Update. 2014;20:124–40.CrossRefPubMed
19.
go back to reference Nardo LG, Gelbaya TA, Wilkinson H, Roberts SA, Yates A, Pemberton P, et al. Circulating basal anti-müllerian hormone levels as predictor of ovarian response in women undergoing ovarian stimulation for in vitro fertilization. Fertil Steril. 2009;92:1586–93.CrossRefPubMed Nardo LG, Gelbaya TA, Wilkinson H, Roberts SA, Yates A, Pemberton P, et al. Circulating basal anti-müllerian hormone levels as predictor of ovarian response in women undergoing ovarian stimulation for in vitro fertilization. Fertil Steril. 2009;92:1586–93.CrossRefPubMed
20.
go back to reference Gleicher N, Weghofer A, Barad DH. Anti-müllerian hormone (AMH) defines, independent of age, low versus good live-birth chances in women with severely diminished ovarian reserve. Fertil Steril. 2010;94:2824–7.CrossRefPubMed Gleicher N, Weghofer A, Barad DH. Anti-müllerian hormone (AMH) defines, independent of age, low versus good live-birth chances in women with severely diminished ovarian reserve. Fertil Steril. 2010;94:2824–7.CrossRefPubMed
21.
go back to reference Brodin T, Hadziosmanovic N, Berglund L, Olovsson M, Holte J. Antimüllerian hormone levels are strongly associated with live-birth rates after assisted reproduction. J Clin Endocrinol Metab. 2013;98:1107–14.CrossRefPubMed Brodin T, Hadziosmanovic N, Berglund L, Olovsson M, Holte J. Antimüllerian hormone levels are strongly associated with live-birth rates after assisted reproduction. J Clin Endocrinol Metab. 2013;98:1107–14.CrossRefPubMed
22.
go back to reference Iliodromiti S, Kelsey TW, Wu O, Anderson RA, Nelson SM. The predictive accuracy of anti-müllerian hormone for live birth after assisted conception: a systematic review and meta-analysis of the literature. Hum Reprod Update. 2014;20:560–70.CrossRefPubMed Iliodromiti S, Kelsey TW, Wu O, Anderson RA, Nelson SM. The predictive accuracy of anti-müllerian hormone for live birth after assisted conception: a systematic review and meta-analysis of the literature. Hum Reprod Update. 2014;20:560–70.CrossRefPubMed
23.
go back to reference Lukaszuk K, Kunicki M, Liss J, Bednarowska A, Jakiel G. Probability of live birth in women with extremely low anti-müllerian hormone concentrations. Reprod Biomed Online. 2014;28:64–9.CrossRefPubMed Lukaszuk K, Kunicki M, Liss J, Bednarowska A, Jakiel G. Probability of live birth in women with extremely low anti-müllerian hormone concentrations. Reprod Biomed Online. 2014;28:64–9.CrossRefPubMed
24.
go back to reference Kedem A, Haas J, Geva LL, Yerushalmi G, Gilboa Y, Kanety H, et al. Ongoing pregnancy rates in women with low and extremely low AMH levels. A multivariate analysis of 769 cycles. PLoS ONE. 2013;8:e81629.CrossRefPubMedPubMedCentral Kedem A, Haas J, Geva LL, Yerushalmi G, Gilboa Y, Kanety H, et al. Ongoing pregnancy rates in women with low and extremely low AMH levels. A multivariate analysis of 769 cycles. PLoS ONE. 2013;8:e81629.CrossRefPubMedPubMedCentral
25.
go back to reference Gianaroli L, Magli MC, Ferraretti AP, Fortini D, Tabanelli C, Gergolet M. Gonadal activity and chromosomal constitution of in vitro generated embryos. Mol Cell Endocrinol. 2000;161:111–6.CrossRefPubMed Gianaroli L, Magli MC, Ferraretti AP, Fortini D, Tabanelli C, Gergolet M. Gonadal activity and chromosomal constitution of in vitro generated embryos. Mol Cell Endocrinol. 2000;161:111–6.CrossRefPubMed
26.
go back to reference Wang JG, Douglas NC, Nakhuda GS, Choi JM, Park SJ, Thornton MH, et al. The association between anti-müllerian hormone and IVF pregnancy outcomes is influenced by age. Reprod Biomed Online. 2010;21:757–61.CrossRefPubMed Wang JG, Douglas NC, Nakhuda GS, Choi JM, Park SJ, Thornton MH, et al. The association between anti-müllerian hormone and IVF pregnancy outcomes is influenced by age. Reprod Biomed Online. 2010;21:757–61.CrossRefPubMed
27.
go back to reference van Loendersloot LL, van Wely M, Limpens J, Bossuyt PM, Repping S, van der Veen F. Predictive factors in in vitro fertilization (IVF): a systematic review and meta-analysis. Hum Reprod Update. 2010;16:577–89.CrossRefPubMed van Loendersloot LL, van Wely M, Limpens J, Bossuyt PM, Repping S, van der Veen F. Predictive factors in in vitro fertilization (IVF): a systematic review and meta-analysis. Hum Reprod Update. 2010;16:577–89.CrossRefPubMed
28.
go back to reference Lee RK, Wu FS, Lin MH, Lin SY, Hwu YM. The predictability of serum anti-müllerian level in IVF/ICSI outcomes for patients of advanced reproductive age. Reprod Biol Endocrinol. 2011;9:115.CrossRefPubMedPubMedCentral Lee RK, Wu FS, Lin MH, Lin SY, Hwu YM. The predictability of serum anti-müllerian level in IVF/ICSI outcomes for patients of advanced reproductive age. Reprod Biol Endocrinol. 2011;9:115.CrossRefPubMedPubMedCentral
29.
go back to reference Bhide P, Gudi A, Shah A, Timms P, Grayson K, Homburg R. Anti-müllerian hormone as a predictor of pregnancy following IVF. Reprod Biomed Online. 2013;26:247–52.CrossRefPubMed Bhide P, Gudi A, Shah A, Timms P, Grayson K, Homburg R. Anti-müllerian hormone as a predictor of pregnancy following IVF. Reprod Biomed Online. 2013;26:247–52.CrossRefPubMed
30.
go back to reference Brodin T, Hadziosmanovic N, Berglund L, Olovsson M, Holte J. Comparing four ovarian reserve markers—associations with ovarian response and live births after assisted reproduction. Acta Obstet Gynecol Scand. 2015;94:1056–63.CrossRefPubMed Brodin T, Hadziosmanovic N, Berglund L, Olovsson M, Holte J. Comparing four ovarian reserve markers—associations with ovarian response and live births after assisted reproduction. Acta Obstet Gynecol Scand. 2015;94:1056–63.CrossRefPubMed
31.
go back to reference Honnma H, Baba T, Sasaki M, Hashiba Y, Oguri H, Fukunaga T, et al. Different ovarian response by age in an anti-müllerian hormone-matched group undergoing in vitro fertilization. J Assist Reprod Genet. 2012;29:117–25.CrossRefPubMedPubMedCentral Honnma H, Baba T, Sasaki M, Hashiba Y, Oguri H, Fukunaga T, et al. Different ovarian response by age in an anti-müllerian hormone-matched group undergoing in vitro fertilization. J Assist Reprod Genet. 2012;29:117–25.CrossRefPubMedPubMedCentral
32.
go back to reference Casadei L, Manicuti C, Puca F, Madrigale A, Emidi E, Piccione E. Can anti-müllerian hormone be predictive of spontaneous onset of pregnancy in women with unexplained infertility? J Obstet Gynaecol. 2013;33:857–61.CrossRefPubMed Casadei L, Manicuti C, Puca F, Madrigale A, Emidi E, Piccione E. Can anti-müllerian hormone be predictive of spontaneous onset of pregnancy in women with unexplained infertility? J Obstet Gynaecol. 2013;33:857–61.CrossRefPubMed
Metadata
Title
IVF results in patients with very low serum AMH are significantly affected by chronological age
Authors
Alberto Revelli
Valentina Biasoni
Gianluca Gennarelli
Stefano Canosa
Paola Dalmasso
Chiara Benedetto
Publication date
01-05-2016
Publisher
Springer US
Published in
Journal of Assisted Reproduction and Genetics / Issue 5/2016
Print ISSN: 1058-0468
Electronic ISSN: 1573-7330
DOI
https://doi.org/10.1007/s10815-016-0675-7

Other articles of this Issue 5/2016

Journal of Assisted Reproduction and Genetics 5/2016 Go to the issue