scholarly journals STUDY OF ANTIMULLERIAN HORMONE (AMH) LEVEL VARIATION IN FEMALES IN ASSISTED REPRODUCTIVE TECHNOLOGY (ART) CENTRE

2020 ◽  
Vol 4 (9) ◽  
Author(s):  
Supeeti Gupta ◽  
VDS Jamwal ◽  
B Subhash ◽  
K Mohanlal
Keyword(s):  
Assisted Reproductive Technology ◽  
Ovarian Reserve ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Ovarian Response ◽  
Controlled Ovarian Hyperstimulation ◽  
Reproductive Technology ◽  
Antimullerian Hormone ◽  
Antimüllerian Hormone ◽  
First Time

Study of AMH levels of patients of ART Centre and its variations has clinical relevance in the field of assisted reproductive technology. Diminished ovarian reserve has become a major cause of infertility. Anti-Mullerian hormone (AMH) seems to be a promising candidate to assess ovarian reserve and predict the response to controlled ovarian hyperstimulation (COH).  The study is a prospective, observational study carried in Department of Anatomy in collaboration with Assisted Reproductive Technology centre at a tertiary care teaching hospital. The study is carried out on eighty females who had reported to ART centre for treatment for the first time, because of involuntary childlessness with at least 1 year of unprotected intercourse without pregnancy.  In our study, eighty females were divided into four groups depending upon their AMH levels. The number of oocytes collected from each female on the day of oocyte pickup was documented. Comparison with previous studies was done. Knowledge of AMH levels will help gynaecologist to counsel the infertility patient prior to initiation of the IVF cycle. It not only allows the quantification of ovarian reserve but also predict the eventual ovarian response to ovarian stimulation and the clinical pregnancy. Keywords: AntiMullerian Hormone, Assisted Reproductive Technology, Ovarian Reserve

scholarly journals Discrepancies between Antimullerian Hormone and Follicle Stimulating Hormone in Assisted Reproduction

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Munawar Hussain ◽  
David Cahill ◽  
Valentine Akande ◽  
Uma Gordon
Keyword(s):  
Follicle Stimulating Hormone ◽  
Ovarian Response ◽  
Controlled Ovarian Hyperstimulation ◽  
Ongoing Pregnancy Rate ◽  
Antimullerian Hormone ◽  
Antimüllerian Hormone ◽  
Group 2 ◽  
Abnormal Group ◽  
Group 1 ◽  
Stimulating Hormone

Data from 107 women undergoing their first IVF/ICSI were analyzed. Relationships between antimullerian hormone (AMH) and follicle stimulating hormone (FSH) were analyzed after dividing patients into four groups according to AMH/FSH levels. Concordance was noted in 57% of women (both AMH/FSH either normal or abnormal) while 43%of women had discordant values (AMH/FSH one hormone normal and the other abnormal). Group 1 (AMH and FSH in normal range) and group 2 (normal AMH and high FSH) were younger compared to group 3 (low AMH and normal FSH) and group 4 (both AMH/FSH abnormal). Group 1 showing the best oocyte yield was compared to the remaining three groups. Groups 3 and 4 required higher dose of gonadotrophins for controlled ovarian hyperstimulation showing their low ovarian reserve. There was no difference in cycle cancellation, clinical pregnancy, and live birth/ongoing pregnancy rate in all groups. These tests are useful to predict ovarian response but whether AMH is a substantially better predictor is not yet established.

scholarly journals The novel POSEIDON stratification of ‘Low prognosis patients in Assisted Reproductive Technology’ and its proposed marker of successful outcome

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 2911 ◽  
Author(s):  
Peter Humaidan ◽  
Carlo Alviggi ◽  
Robert Fischer ◽  
Sandro C. Esteves
Keyword(s):  
Assisted Reproductive Technology ◽  
Ovarian Reserve ◽  
Prediction Models ◽  
Live Birth Rate ◽  
Ovarian Response ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Reproductive Technology ◽  
Successful Outcome ◽  
Specific Patient

In reproductive medicine little progress has been achieved regarding the clinical management of patients with a reduced ovarian reserve or poor ovarian response (POR) to stimulation with exogenous gonadotropins -a frustrating experience for clinicians as well as patients. Despite the efforts to optimize the definition of this subgroup of patients, the existing POR criteria unfortunately comprise a heterogeneous population and, importantly, do not offer any recommendations for clinical handling. Recently, the POSEIDON group (Patient-Oriented Strategies Encompassing IndividualizeD Oocyte Number) proposed a new stratification of assisted reproductive technology (ART) in patients with a reduced ovarian reserve or unexpected inappropriate ovarian response to exogenous gonadotropins. In brief, four subgroups have been suggested based on quantitative and qualitative parameters, namely, i. Age and the expected aneuploidy rate; ii. Ovarian biomarkers (i.e. antral follicle count [AFC] and anti-Müllerian hormone [AMH]), and iii. Ovarian response - provided a previous stimulation cycle was performed. The new classification introduces a more nuanced picture of the “low prognosis patient” in ART, using clinically relevant criteria to guide the physician to most optimally manage this group of patients. The POSEIDON group also introduced a new measure for successful ART treatment, namely, the ability to retrieve the number of oocytes needed for the specific patient to obtain at least one euploid embryo for transfer. This feature represents a pragmatic endpoint to clinicians and enables the development of prediction models aiming to reduce the time-to-pregnancy (TTP). Consequently, the POSEIDON stratification should not be applied for retrospective analyses having live birth rate (LBR) as endpoint. Such an approach would fail as the attribution of patients to each Poseidon group is related to specific requirements and could only be made prospectively. On the other hand, any prospective approach (i.e. RCT) should be performed separately in each specific group.

scholarly journals SAT-002 Does the Age of Women Influence the Evaluation of Ovarian Reserve Through the Determination of Antimullerian Hormone and Follicle Count?

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Patricia Nieves Amelia Maidana ◽  
Nancy Bravo Briones ◽  
Vanesa Aparicio ◽  
Delfina Ronconi ◽  
Juan Manuel Bonomo ◽  
...  
Keyword(s):  
Ovarian Reserve ◽  
Transvaginal Ultrasound ◽  
Ovarian Response ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Positive Correlation ◽  
Antimullerian Hormone ◽  
Antimüllerian Hormone ◽  
Group 2 ◽  
Group 1

Abstract INTRODUCTION: Oocyte number and quality are known to decline with age. However, fertility varies significantly even among women of the same age. Given that maternal age has been delayed in recent years, an ovarian biomarker that could reflect follicular activity with precision and accuracy is needed in reproductive medicine. In recent years, two key methods, the concentration of serum antimüllerian hormone (AMH), which reflects the number of small antral follicles and is predictive of ovarian response, and antral follicle count (AFC) performed by ultrasonography, have emerged as preferred methods for assessing ovarian reserve. AIM: To assess the influence of women’s age in the association between AMH serum level and antral follicle count by ultrasonography in the evaluation of ovarian reserve SUBJECTS AND METHODS: 49 women between 25 and 45 years old who attended our laboratory with request for AMH and transvaginal ultrasound in early follicular phase were included in the study. In all of them serum AMH was tested using an electrochemiluminescence immunoassay (ECLIA) on a Roche Diagnostic Cobas e801 analyzer. Transvaginal ultrasonography follicle count was performed in both ovaries by Philips affinity 70 on first days of the menstrual cycle. Statistical analysis was performed through SPSS 23 software. RESULTS: Median and ranges of the variables are the following: AMH: 0.78 (<0.03-9.98) ng/ml and AFC: 6 (1.0-60.0) follicles. AMH and AFC were negatively associated with age (r: -0.302, p< 0.01; r: -0.267 p<0.01, respectively). AMH showed a positive correlation with AFC (r=0.567,p<0.01). We then divided the study population in two subgroups, according to age: Group 1, women <40 years old(n=28) and Group 2, women ≥40 years old (n=21).Considering AMH= 1ng/ml and AFC = 7, the cut-off value used routinely in our institution, we calculated the Kappa coefficient in each group to test the degree of agreement between these two variables, with the following results: Group 1, Kappa= 0.4510, CI 95% [0.1566 – 0.7453], p= 0.0088; Group 2, Kappa= -0.0370, CI 95% [-0.4371 – 0.3630], p=ns. CONCLUSION: despite the positive correlation found between AMH levels and AFC in the whole group, Kappa values show that in women younger than 40 years serum AMH>1 ng/ml is a good predictor of AFC >7, but this agreement is lost in women above this age, with the cut-off values used in this study. These results must be confirmed with a larger group of women.

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