Impact of antimullerian hormone assays on the outcomes of in vitro fertilization: a prospective controlled study

Objective: To assess the value of routine antimullerian hormone (AMH) assays in patients considered high risk for cancellation. Design: Prospective controlled study. Setting: A private IVF center, Cairo, Egypt. Patient(s): In total 4,917 patients received counseling before starting IVF/intracytoplasmic sperm injection (ICSI). They were comprised of group A1 (n = 1,335), who were considered to be at risk for cancellation after ovarian stimulation, and group A2 (n = 3,582), who were considered low risk for cancellation. A control group, B (n = 4,639), included group B1 (n = 1,248) and group B2 (n = 3,391) based on the same criteria as groups A1 and A2. Intervention(s): An AMH assessment was performed for group A1. All of the patients were stimulated using the long GnRH agonist protocol. Patients with low AMH levels received the flare-up protocol. Main Outcome Measure(s): The cancellation of IVF/ICSI cycles before or after stimulation, as well as the pregnancy rates ( PR) in relation to AMH levels. Result(s): The group A1 patients (6.4%) did not start IVF due to low AMH, and some (6.6%) had their cycles canceled due to poor responses, compared with 2.6% in group A2 and 13.2% in group B1. The clinical PR was 42% in patients with normal AMH and 20% in patients with low AMH. The differences among these three groups were highly significant. Conclusion(s): The AMH assays reduced the cancellations, cost, and stress experienced by couples. (Fertil Steril (R) 2014; 101: 134-7. (C) 2014 by American Society for Reproductive Medicine.)