Diagnostic importance of serum anti-mullerian hormone in comparison to other sex hormones in in vitro fertilization

Author: 
Bushra Fiza., Rati Mathur and Maheep Sinha

Introduction: In vitro fertilization (IVF) is an assisted reproductive technology (ART) technique commonly used for infertile couples. For successful outcome of IVF, optimal evaluation of women and standardized screening protocol is necessary. The success of IVF depends on a good ovarian response. Various endocrine and clinical markers have been proposed to predict the ovarian response though they have limited predictive value. Anti-mullerian hormone, a member of transforming growth family, has recently been suggested as a reliable marker of ovarian response.

Aims and objectives: The present study was planned to assess the reliability of AMH as marker of ovarian response and its comparison with other contemporary endocrine markers.

Materials and methods: Based on standardized initial screening, 155 females were selected for IVF. Day 3 AMH, LH, FSH and Estradiol (E2) levels were estimated. The females were subjected to ovulation induction and grouped on the basis of no. of oocytes retrieved as poor (<5), normal (5-8) and good responders (>8). The hormone levels were presented as mean + SD and subjected to statistical analysis.

Result and discussion: The study proposed that low S. AMH levels can predict a poor ovarian response. A cut off value of 0.6 ng/ml was proposed for S. AMH level as indicative of poor response. AMH was observed to have a strong correlation with age (r = -0.484), no of oocytes retrieved (r = 0.844) and S. FSH (r = -0.342).

Conclusion: The study proposes S. AMH to be a reliable marker of the reproductive potential in females especially in advanced reproductive age and its optimal evaluation can serve as a tool not only for deciding the treatment protocol but also for patient counseling. Baseline estimation of S. AMH can be helpful in decreasing the cycle cancellation rate and increasing the IVF success rate.

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DOI: 
DOI: http://dx.doi.org/10.24327/ijcar.2017.4745.0573
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