Association Between AMH Levels and Fertility/Reproductive Outcomes Among Women Undergoing IVF: A Retrospective Study

Asha Srinivasan  Vijay; Murali Mohan Reddy  Gopireddy; Syed  Fyzullah; Priyanka  Gollapalli; M  Maheswar; Usha  Rani; Swathi  Rajesh

doi:10.18502/jri.v23i1.8453

Asha Srinivasan Vijay Scientific Director and Dean, GarbhaGudi Institute of Reproductive Health and Research (GGIRHR), Hanumanthnagar, Bangalore, India
Murali Mohan Reddy Gopireddy Evidence Generation, Evidencian Research Associates, Bangalore
Syed Fyzullah Department of Embryology, GarbhaGudi Institute of Reproductive Health and Research (GGIRHR), Hanumanthnagar, Bangalore, India
Priyanka Gollapalli Evidence Generation, Evidencian Research Associates, Bangalore
M Maheswar Department of Reproductive Medicine, GarbhaGudi Institute of Reproductive Health and Research (GGIRHR), Hanuman-thnagar, Bangalore, India
Usha Rani Department of Embryology, GarbhaGudi Institute of Reproductive Health and Research (GGIRHR), Hanumanthnagar, Bangalore, India
Swathi Rajesh Department of Embryology, GarbhaGudi Institute of Reproductive Health and Research (GGIRHR), Hanumanthnagar, Bangalore, India

DOI: https://doi.org/10.18502/jri.v23i1.8453

Keywords: Anti-mullerian hormone, Fertilization, Pregnancy rate.

Abstract

Background: Anti-mullerian hormone (AMH) is a marker for predicting ovarian response to gonadotropin stimulation. It plays an important role in ovarian primordial follicle recruitment and dominant follicle selection. Therefore, the present study evaluated the AMH levels and their association with oocyte morphology, embryo quality, clinical pregnancy rate, and fertility outcome among women undergoing IVF.

Methods: A retrospective study was conducted on 665 women in GarbhaGudi Institute of Reproductive Health and Research in India from October 2018 to 2019. Subjects were divided into ³1.1 and £1.1 AMH level groups. Data on age, luteinizing hormone; LH (mIU/L), follicle-stimulating hormone values; FSH (mIU/ml), LH value, oocytes retrieved, and oocytes fertilization were collected. AMH category was considered as the primary explanatory variable. Independent sample t-test and chi-square tests were performed. The p<0.05 was considered statistically significant.

Results: Couple’s age, FSH values (mIU/ml), number of large follicles, matured oocytes, fertilized oocytes, and cleaved embryos were statistically significant among subjects with ³1.1 AMH values (p<0.001). Percentage of women with successful embryo transfer was slightly higher among AMH category 1.1 (p=0.09). Fertilization rate (p=0.18) and clinical pregnancy rate (p=0.19) were slightly higher among women with AMH level ³1.1 as compared to AMH<1.1. Live birth rate was slightly higher among women with AMH level 1.1 (p=0.45). In optimal regression model, only the number of fertilized oocytes was associated with clinical pregnancy rate (aOR=1.20, 95%CI 1.09-1.33; p<0.001).

Conclusion: Women with ³1.10 serum AMH levels had more number of retrieved oocytes, good oocyte quality, increased embryo transfer, and fertilization rates.