What is the optimal threshold of serum Anti-Müllerian hormone (AMH) necessary for IVM treatments?

J Assist Reprod Genet. 2013 Jun;30(6):745-51. doi: 10.1007/s10815-013-9996-y. Epub 2013 Apr 23.

Abstract

Purpose: To assesse circulating levels of Anti-Müllerian hormone (AMH) as a predictor of oocyte number and their potential to mature in vitro in both normo-ovulatory (NO) women and in women with Polycystic Ovary Syndrome (PCOS) undergoing in vitro maturation (IVM) treatments.

Methods: We prospectively studied NO women and women diagnosed with PCOS, (age range 21-39 years) underwent IVM treatments at our center. Serum AMH levels were quantified before each cycle and correlated to oocytes number, maturation and fertilization during in vitro maturation.

Results: 104 NO and 30 PCOS IVM cycles were followed with retrieval of a total of 672 and 491 oocytes, respectively. In NO women, the serum AMH level positively correlated with the number of oocytes retrieved, (R = 0.6; P <0.0001) the number of M2 oocytes at 24 and 48 h (R = 0.4; P <0.01; R = 0.26 p < 0.007, respectively) and with the total number of M2 oocytes (R = 0.47; P < 0.0001). In the PCOS group, the serum AMH level positively correlated only with the number of oocytes retrieved (R = 0.43; P <0.03). Receiver operating characteristic (ROC) analyses showed that a cutoff AMH level of 1.56 (ng/ml) could identify patients with 5 or more oocytes at OPU with a sensitivity of 83 % and a specificity of 75 %. An AMH level of 1.63 (ng/ml) was the threshold for 5 or more matured oocytes (sensitivity = 81 %, specificity = 53 %).

Conclusions: Serum AMH may be used as a marker to identify candidates for IVM treatment in both NO and PCOS women.

MeSH terms

  • Adult
  • Aged
  • Anti-Mullerian Hormone / blood*
  • Anti-Mullerian Hormone / isolation & purification
  • Biomarkers / blood
  • Female
  • Fertilization in Vitro / methods
  • Humans
  • In Vitro Oocyte Maturation Techniques
  • Oocytes / growth & development*
  • Oocytes / metabolism
  • Oogenesis*
  • Ovarian Follicle / growth & development
  • Polycystic Ovary Syndrome / blood*
  • Polycystic Ovary Syndrome / pathology
  • Pregnancy
  • Young Adult

Substances

  • Biomarkers
  • Anti-Mullerian Hormone