Serum antimullerian hormone concentrations on day 3 of the in vitro fertilization stimulation cycle are predictive of the fertilization, implantation, and pregnancy in polycystic ovary syndrome patients undergoing assisted reproduction

Objective: To determine the possible relationship between serum antimullerian hormone (AMH) concentrations on day 3 and controlled ovarian stimulation and reproductive outcomes in women with polycystic ovary syndrome. Design: Prospective, clinical trial. Setting: University hospital. Patient(s): Sixty women with PCOS. Intervention(s): Serum concentrations of AMH measured on cycle day 3. Main Outcome Measure(s): Clinic pregnancy rate (CPR), implantation rate (IR), and fertilization rate (FR). Result(s): The CPR, IR, and FR were markedly different among the day-3 serum AMH groups (low, moderate, and high AMH groups). The CPR were 33.3, 46.1, and 60.0, respectively, in the low, moderate, and high serum AMH groups on day 3. The embryo IR were 18.6, 26.7, and 36.3, respectively. The FR were 54, 68, and 79, respectively. An AMH level >= 3.01 ng/mL was shown to predict FR with a sensitivity of 86.4% and specificity of 75%. An AMH level >= 3.2 ng/mL was shown to predict IR and CPR with sensitivity and specificity of 72.1% and 72.7%, and 75.6% and 77.3%, respectively. Conclusion(s): On day 3 of the in vitro fertilization stimulation cycle, serum concentrations of AMH can be used as a marker for ovarian response as well as reproductive outcome in assisted reproductive cycles of PCOS patients. (Fertil Steril (R) 2010; 94: 2202-7. (C) 2010 by American Society for Reproductive Medicine.)