Hum. Reprod. Advance Access published online on July 18, 2007
Human Reproduction, doi:10.1093/humrep/dem204
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Serum anti-Müllerian hormone and FSH: prediction of live birth and extremes of response in stimulated cycles—implications for individualization of therapy
1 Reproductive and Maternal Medicine, Division of Developmental Medicine, University of Glasgow, 10 Alexandra Parade, Glasgow G31 2ER, UK 2 Assisted Conception Unit, Glasgow Royal Infirmary, Glasgow G31 2ER, UK
3 Correspondence address. Tel: +44 141 211 4706; Fax: +44 141 552 0873; E-mail: s.nelson{at}clinmed.gla.ac.uk
BACKGROUND: Serum concentrations of anti-Müllerian hormone (AMH) correlate with oocyte yield in assisted reproduction treatment (ART) cycles, however, performance of AMH for prediction of live birth is unknown.
METHODS: A total of 340 first cycle IVF/ICSI patients (median age 34.0 years, inter-quartile range 31.0–37.0 years), had basal plasma AMH and FSH measured and their predictive values for live birth and oocyte yield compared.
RESULTS: AMH predicts live birth [contribution to variance (CTV) 3.84%, P < 0.001] and oocyte yield (r = 0.71, P < 0.0001, CTV 7.3%, P < 0.0001). Compared with age and FSH, AMH performs better in prediction of live births [area under receiver operating characteristic curve (AUC) 0.62, 95% CI 0.55–0.68; FSH AUC 0.42, 95% CI 0.35–0.49; age AUC 0.48, 95% CI 0.41–0.55, P = 0.0028] and excessive response to ovarian stimulation (AMH AUC 0.90, 95% CI 0.83–0.96; FSH AUC 0.32, 95% CI 0.23–0.40; age AUC 0.57, 95% CI 0.43–0.71, P < 0.001). AMH prediction of oocyte yield is independent of age (r = –0.28, P < 0.0001, CTV 1.4%, P = 0.006), however, a significant negative interaction (CTV 3.6%, P < 0.0001) exists. AMH demonstrates improved differential distributions for non-, poor, normal and excessive ovarian responses relative to FSH and age.
CONCLUSIONS: Plasma AMH is a superior predictor of live birth and anticipated oocyte yield compared with FSH and age, facilitating individualization of therapy prior to first ART cycle.
Key words: anti-Müllerian hormone/live birth/controlled ovarian stimulation
Submitted on February 14, 2007; resubmitted on June 6, 2007; accepted on June 13, 2007.
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