A Novel Counseling Tool: AMH as a Predictor of Oocyte Yield and Live Birth Rate (LBR) With Oocyte Cryopreservation (OC) [29M]

• Published in: Obstetrics and gynecology (New York. 1953) Vol. 133 Suppl 1; no. 1; p. 149S
• Main Authors: Maslow, Bat-Sheva L, Ramirez, Leslie B, Klein, Joshua U
• Format: Journal Article
• Language: English
• Published: by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved 01-05-2019
• ISSN: 0029-7844; 1873-233X
• DOI: 10.1097/01.AOG.0000559302.76598.b7

INTRODUCTION:Methods for counseling women regarding candidacy for OC are limited. This study aims to provide a novel evidence-based tool to interpret serum AMH as a predictor of oocyte yield and LBR in non-infertile women considering OC.
METHODS:All OC cycles performed at Extend Fertility Medical Practice from 4/2016 through 8/2018 were included. The study was granted IRB exempt status. AMH levels were performed at an independent laboratory using Gen-II ELISA platform. Using published data, the number of oocytes needed for a 50% LBR were calculated per age group. ROC curves for each age group were used to select appropriate cutoffs based on accuracy and simplicity. Associations were made using X2.
RESULTS:1385 cycles were included. Mean age at cycle start was 36.1+/-3.2. Median AMH 1.83 ng/mL [IQR 1.11-3.12]. Predicted 50% LBR was equivalent to 7 cryopreserved MII oocytes at age ≤34, 9 at 35-37, 11 at 38-40, 20 at ≥-41. ROC curve demonstrated good fit for AMH as a predictor of 50% LBR at each age group (AUC 0.80-0.86, P<.001-.016). Suggested AMH to achieve a predicted 50%LBR with 1 cycle of OC are as follows≤34=1.25 (P<.001, OR 4.54 CI 2.61-7.899)35-37=1.50 (P<.001, OR 5.23 CI 3.67-7.44)38-40=1.75 (P<.001 OR 7.97 CI 4.4-14.38)≥41=2.25 (P=.002 OR 1.01-1.60)
CONCLUSION:Appropriate estimates of per cycle oocyte yield and predicted live birth rates based on age at cryopreservation are critical for enabling women to make informed decisions about their reproductive goals. These data provide a novel method with which to counsel women about their candidacy for OC.