Anti-mullerian hormone levels can help predict outcome of in-vitro maturation treatment

This paper studied whether anti-mullerian hormone levels can predict outcomes of in-vitro maturation in women with PCOS. Authors concluded that in-vitro maturation could be considered in women with high levels of anti-mullerian hormone.

Polycystic ovarian syndrome (PCOS) is a condition where many cysts grow in the ovaries. This leads to problems where the egg is not released from the ovary. Women with PCOS often find it difficult to get pregnant. In-vitro maturation is a process where an immature egg is removed from the ovary and allowed to mature and fertilize outside the body, before being implanted back into the uterus. It has been suggested that in-vitro maturation may be beneficial for PCOS patients as it reduces the risk of over-stimulation of the ovaries. However, in-vitro maturation is associated with lower pregnancy rates compared to in-vitro fertilization (IVF). The level of anti-mullerian hormone in a woman's blood is generally a good indicator of fertility. Testing for anti-mullerian hormone levels could therefore help identify those patients who would benefit from in-vitro maturation.

The records of 186 women with PCOS who underwent in-vitro maturation were studied. Anti-mullerian hormone levels were measured in all women. The average number of immature eggs retrieved was 16.15.

The overall birth rate was 30.1%. Patients who had a live birth had an average anti-mullerian hormone level of 12.29. This was significantly higher compared to the average anti-mullerian hormone level in patients who did not have a live birth (9.44).

Anti-mullerian hormone level was found to predict the likelihood of live birth after in-vitro maturation. Those who had anti-mullerian hormone levels of greater than 8.5 were 2 times more likely to have live birth than those who had anti-mullerian hormone levels of less than 8.5. Patients who had more than 5 fertilized eggs were 3 times more likely to have live birth than those who had less than 5 fertilized eggs.

Patients who underwent in-vitro maturation were also compared to those who underwent conventional IVF. The pregnancy rate and live birth rate were comparable. There were no cases of ovarian hyperstimulation syndrome (painful, swollen ovaries, considered a serious complication) among those who underwent in-vitro maturation. 

The authors concluded that anti-mullerian hormone levels are a useful test for women with PCOS who are planning to undergo in-vitro maturation as an alternative to IVF.