Negligible serum anti-müllerian hormone: pregnancy and birth after a 1-month course of an oral contraceptive, ovarian hyperstimulation, and intracytoplasmic sperm injection

Fertil Steril. 2009 Jul;92(1):395.e9-395.e12. doi: 10.1016/j.fertnstert.2009.03.044. Epub 2009 May 1.

Abstract

Objective: To describe a patient with isolated negligible (<0.5 ng/mL or <3.6 pmol/L) anti-müllerian hormone (AMH) levels who underwent intracytoplasmic sperm injection (ICSI) for severe oligoasthenoteratozoospermia, displayed ovarian hyperstimulation after a 1-month course of an oral contraceptive (OC), had a singleton pregnancy and delivered a healthy boy.

Design: Case report.

Setting: Reproductive center at a private hospital.

Patient(s): A 34-year-old woman with isolated negligible (<0.5 ng/mL or <3.6 pmol/L) AMH level and poor response to controlled ovarian hyperstimulation (COH) and her 38-year-old partner with severe oligoasthenoteratozoospermia.

Intervention(s): A 1-month course of an OC, modified minimal stimulation cycle with recombinant FSH, antagonist (cetrorelix) administration to inhibit LH surge, triggered ovulation using 10,000 U of hCG and ICSI.

Main outcome measure(s): Level of AMH, pregnancy, and birth.

Result(s): Three high quality embryos were obtained and transferred 48 hours after ICSI. Transvaginal ultrasound at 8 weeks' gestation showed a vital singleton pregnancy. The pregnancy continued uncomplicated. The patient gave birth to a healthy boy, weighing 3,280 g, by caesarean section at 39 weeks' gestation.

Conclusion(s): Ovarian hyperstimulation, pregnancy, and birth may occur after a short course of an OC and ICSI in poor responder, normogonadotropic, regularly menstruating young women with isolated negligible AMH.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Mullerian Hormone / blood*
  • Anti-Mullerian Hormone / deficiency
  • Cesarean Section
  • Enzyme-Linked Immunosorbent Assay
  • Estradiol / blood
  • Female
  • Follicle Stimulating Hormone / blood
  • Humans
  • Infant, Newborn
  • Karyotyping
  • Live Birth
  • Male
  • Ovulation Induction / methods*
  • Pregnancy
  • Sperm Injections, Intracytoplasmic*

Substances

  • Estradiol
  • Anti-Mullerian Hormone
  • Follicle Stimulating Hormone