Anti-Mullerian Hormone Cannot Predict Oocyte Quality and Pregnancy Outcome in Women with Diminished Ovarian Reserve

OBJECTIVE: To compare anti-Mullerian hormone (AMH) levels in serum and follicular fluid (FF) among women < 40 yrs with diminished ovarian reserve (DOR), advanced age (AA) women (> 40 yrs), and age-matched women (< 40 yrs) with normal ovarian reserve (NOR) and to explore the relationship of AMH with oocyte quality and pregnancy outcome. STUDY DESIGN: Serum and FF AMH levels and oocyte quality, clinical pregnancy rate (CPR), and live birth rate (LBR) were analyzed in 149 women. RESULTS: Both serum and FF AMH concentrations were significantly lower in DOR and AA as compared with those in NOR (median serum AMH: 0.33 ng/mL vs. 0.51 ng/mL vs. 2.35 ng/mL; median FF AMH: 2.32 ng/mL vs. 2.66 ng/mL vs. 6.77 ng/mL, p<0.01). The rate of good-quality embryos on D2 was comparable among the 3 groups. A 2-fold higher CPR was found in NOR than DOR (62.79% vs. 38.3%, p<0.01), along with a remarkably higher LBR (60.47% vs. 31.91%, p<0.01). The lowest CPR and LBR were observed in AA (17.5%; 5.00%). No association of either serum or FF AMH with CPR, LBR, and the rate of good-quality embryos on D2 was indicated. CONCLUSION: AMH cannot predict either oocyte quality or pregnancy outcome in a DOR population. A better pregnancy outcome could be anticipated in younger women with DOR as compared with AA women.