Anti-Mullerian hormone as a predictor of IVF outcome

Serum anti-Mullerian hormone (AMH) concentration and antral follicle count (AFC) are two increasingly popular static measures used to predict ovarian reserve prior to IVF treatment. While they have been shown to be good predictors of oocyte yield during ovarian stimulation, their status as indicators of oocyte quality and pregnancy rates is currently uncertain. The present study measured baseline concentrations of serum AMH and FSH, and AFC from 126 women undergoing IVF treatment. These data were then related to IVF outcomes. As expected, patients with lower serum AMH and AFC produced a significantly (P < 0.001) lower number of oocytes compared with patients with higher serum AMH/AFC. Fertilization rates in patients with lower serum AMH were significantly inferior compared with patients with higher serum AMH, irrespective of whether IVF (P = 0.043) or intracytoplasmic sperm injection (P = 0.006) was used to achieve fertilization. These low AMH patients yielded fewer oocytes, had lower fertilization rates, generated fewer embryos, and had a higher incidence of miscarriage during fresh transfers, ultimately culminating in a halving of the pregnancy rate per IVF cycle compared with the high AMH group.