Is low antimullerian hormone associated with poorer IVF outcomes?

This study investigated if anti-mullerian hormone (AMH) levels affect in vitro fertilization (IVF) outcomes. 

They found that low AMH was associated with reduced live birth rate (LBR). 

Infertility is a significant issue for many couples. Many couples will undergo in vitro fertilization (IVF) in order to become pregnant. The most common cause of female infertility is diminished ovarian reserve (OR). OR can be determined by measuring two hormones. These are follicle-stimulating hormone (FSH) and anti-mullerian hormone (AMH). If FSH or AMH levels are outside the normal range then there may be diminished OR.

Normal AMH levels in fertile women are linked to better fertility outcomes. It is unclear if AMH levels are associated with fertility outcomes in patients undergoing IVF.

This study included 44,696 women that underwent IVF. The authors used medical records to compare AMH and FSH levels with fertility outcomes. The main outcome measured was the live birth rate (LBR). Patient characteristics were also evaluated. These included age and body mass index (BMI). 

38% of IVF cycles lead to a live birth. The LBR was highest in women with normal FSH and AMH (44%). 19% of women with high FSH/low AMH (both hormones abnormal) achieved a live birth.

In patients with only one abnormal hormone, LBR was higher in women with high FSH/normal AMH (39%) compared to normal FSH/low AMH (26%). IVF failure (or cancellation) was higher in low AMH patients. Patients aged 40 years or over and with a BMI greater than 30 also had lower LBR.

The authors concluded that low AMH was associated with reduced LBR in women undergoing IVF.

This study looked back at medical records. The treatment protocols varied between patients. FSH can be difficult to measure and may be a source of variability. More investigation is needed.