Serum antimüllerian hormone measurements with second generation assay at two distinct menstrual cycle phases for prediction of cycle cancellation, pregnancy and live birth after in vitro fertilization

• Published in: Journal of assisted reproduction and genetics Vol. 31; no. 10; pp. 1303 - 1310
• Main Authors: Rezende, Carolina P., Rocha, Ana L., Dela Cruz, Cynthia, Borges, Lavinia E., Del Puerto, Helen L., Reis, Fernando M.
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01-10-2014; Springer Nature B.V
• Subjects: Adult; Anti-Mullerian Hormone - blood; Assisted Reproduction Technologies; Clinical outcomes; Embryos; Female; Fertilization in Vitro - methods; Follicle Stimulating Hormone - blood; Follicles; Gynecology; Human Genetics; Humans; In vitro fertilization; In Vitro Techniques - methods; Infertility; Infertility, Female - blood; Infertility, Female - metabolism; Infertility, Female - therapy; Live Birth; Medicine; Medicine & Public Health; Menstrual Cycle - blood; Menstrual Cycle - metabolism; Menstruation; Ovarian Follicle - metabolism; Ovaries; Ovulation Induction - methods; Pregnancy; Prospective Studies; Reproductive Medicine; ROC Curve; Ultrasonic imaging; In vitro fertilization; Pregnancy; Antimüllerian hormone; Live birth; Menstrual cycle
• DOI: 10.1007/s10815-014-0289-x
• EISSN: 1573-7330
• ISSN: 1058-0468

Purpose
This study investigated the usefulness of serum antimüllerian hormone (AMH) measurements at two distinct menstrual cycle phases to predict in vitro fertilization (IVF) outcomes.
Methods
This was a prospective observational study enrolling 135 consecutive patients referred for conventional IVF or ICSI in a university hospital. Blood samples were obtained for serum AMH measurements on days 3 and 18–20, while transvaginal ultrasound was performed for antral follicle count (AFC) at day 3 of the menstrual cycle immediately before treatment. AMH was measured with the new Beckman Coulter Generation II (GenII) assay. The main outcome measures were cycle cancellation due to poor ovarian response, clinical pregnancy, and live birth.
Results
There was a strong correlation between AMH levels measured at day 3 and day 18–20 of the menstrual cycle (r = 0.837;
P
 < 0.0001). Day 18–20 serum AMH was comparable to day 3 serum AMH and AFC for the prediction of cycle cancellation (areas under the ROC curve were 0.84 for day 3 AMH, 0.89 for day 18–20 AMH, and 0.80 for AFC). Day 18–20 AMH had a modest predictive value for pregnancy or live birth (area under ROC curve 0.71 for both), which was comparable to that of day 3 AMH; however, AFC had no predictive value for these outcomes.
Conclusions
Day 18–20 AMH was comparable to day 3 AMH for the prediction of cycle cancellation, clinical pregnancy, and live birth after IVF. Both AMH measurements were accurate for the prediction of cancellation but were significantly less useful for the prediction of pregnancy or live birth.