Document Type : Original Article
Authors
1
Department of Obstetrics and Gynecology, Faculty of Medicine-Minia University.
2
Department of Obstetrics and Gynecology, Faculty of Medicine-Minia University
Abstract
Introduction: The role of AMH in the ovary is to participate in the regulation of ovarian function,
especially in follicle development and selection. It inhibits the initiation of human primordial follicle
growth and prevents multiple selection of a dominant follicle by reducing the sensitivity of follicles to
follicle stimulating hormone (FSH). Several reports suggest that AMH might be a better predictor of
ovarian responses to controlled ovarian hyperstimulation (COS) than traditional parameters such as age,
FSH, estradiol (E2) and inhibin B (INH-B). So, the objective of this study was to investigate the predictive
value of anti-Mullerian hormone (AMH) on fertilization rate (FR), implantation rate, blastocyst
development, embryo quality, chemical pregnancy, clinical pregnancy and ongoing pregnancy after ICSI.
Method: In this prospective clinical trial outcomes were followed in 60 women undergoing cycles of
IVF/ICSI within El-Minia university hospital. AMH concentration was estimated in pooled FF on day of
oocyte pickup. Cycles were sorted into low and high groups according to median (50 th centile) values of
measurement. The fertilization rate (FR), implantation rate, blastocyst development, embryo quality,
chemical pregnancy, clinical pregnancy and ongoing pregnancy after ICSI were counted as the main
outcomes. Results: Low FF AMH group shows significantly higher percentage of top-quality oocytes
(67.1±24.3 vs. 49.6 ± 30.3 %, P =0.014), fertilization rate (83.9±20.9 vs. 72.4 ±21.4%, P =0.021), clinical
pregnancy (57.57 vs. 16.67%, P >0.0001), and embryo implantation rates (57.7 vs. 16.7% , P =0.001)
compared to high FF AMH group. FF AMH shares an inverse correlation with FF E2 (Pearson r =
−0.409, p <0.001) and clinical pregnancy (Pearson r = −0.618, p<0.001). Threshold value of FF AMH for
pregnancy is >1.75 ng/mg protein. Receiver operating characteristic analysis showed that the sensitivity
of FF AMH at predicting CPR was 73.1 %; the specificity was 85.3 % and ROCAUC was 0.715
(P < 0.0001). Conclusion: FF AMH is a plausible specific indicator of functional viability and quality of
oocyte in IVF cycles.
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