In a nutshell
This study examined the accuracy of anti-Mullerian hormone in predicting pregnancy success.
Some background
Tests that identify women who require fertility treatment currently measure the ovarian reserve (number of eggs remaining in the ovary). Measures of ovarian reserve such as follicle-stimulating hormone (FSH) have low accuracy. Levels of anti-Mullerian hormone (AMH) in the blood are believed to be more accurate in predicting ovarian reserve. Women with high levels of AMH tend to respond better to ovarian stimulation (using drugs to encourage the maturation of eggs for release) during in vitro fertilization (IVF, when the sperm fertilizes the egg in a laboratory dish outside the body, and doctors implant it into the woman's uterus). Low levels of AMH occur when a low number of eggs remain in the ovaries. However, it is not known whether low levels of AMH accurately indicate a low rate of pregnancy success.
Methods & findings
This study aimed to determine the pregnancy success rate in women with low levels and extremely low levels of AMH. This study involved 181 women who were undergoing in vitro fertilization-intracytoplasmic sperm injection (IVF-ICSI, when a single sperm is injected directly into the egg prior to IVF). Participants were divided into 2 groups. 77 women had extremely low AMH levels (less than 0.2 ng/ml). 111 women had low AMH levels (0.21-1.0 ng/ml).
The number of eggs and number of fertilized eggs were lower in the group of patients that had extremely low levels of AMH. However, the pregnancy rate per cycle (4.4%) was similar in both groups. Both groups saw 20% cumulative pregnancy rates following 5 cycles.
Patients 42 years or older had much lower ongoing pregnany rates (1.6%) compared to women younger than 42 years.
The bottom line
This study concluded that patients with low or extremely low levels of AMH have similar pregnancy rates. AMH levels should therefore not be used to exclude couples from fertility treatment.
The fine print
The sample size for the number of patients older than 48 years of age was quite small.
What’s next?
Consult your physician regarding the criteria used to determine whether additional fertility treatment is an option.
Published By :
PLOS ONE
Date :
Dec 16, 2013
