Prognostic indicators of assisted reproduction technology outcomes of cycles with ultralow serum antimüllerian hormone: a multivariate analysis of over 5,000 autologous cycles from the Society for Assisted Reproductive Technology Clinic Outcome Reporting

Abstract:

OBJECTIVE:To assess cycle outcomes when antimüllerian hormone (AMH) is ultralow (≤0.16 ng/mL) and to determine which parameters contribute to the probability of cycle cancellation and/or outcome. DESIGN:Retrospective analysis. SETTING:Not applicable. PATIENT(S):5,087 (7.3%) fresh and 243 (1.5%) thawed cycles with ultralow AMH values. INTERVENTION(S):Linear and logistic regression, comparison with age-matched cycles with normal AMH concentrations. MAIN OUTCOME MEASURE(S):Cancellation rate; number of retrieved oocytes, embryos, transferred embryos, and cryopreserved embryos; clinical pregnancy, live-birth, and multiple birth rates. RESULT(S):The total cancellation rate per cycle start for fresh cycles was 54%. Of these, 38.6% of the cycles were canceled before retrieval, and 3.3% of cycles obtained no oocytes at time of retrieval. Of all retrieval attempts, 50.7% had three oocytes or fewer retrieved, and 25.1% had no embryo transfer. The live-birth rates were 9.5% per cycle start. Cycles with ultralow AMH levels compared with age-matched normal AMH cycles demonstrated more than a fivefold greater pre-retrieval cancellation rate, a twofold less live-birth rate per cycle and a 4.5-fold less embryo cryopreservation rate. CONCLUSION(S):Refusing treatment solely on the basis of ultralow AMH levels is not advisable, but patients should be counseled appropriately about the prognostic factors for cancellation and outcomes.

journal_name

Fertil Steril

journal_title

Fertility and sterility

authors

Seifer DB,Tal O,Wantman E,Edul P,Baker VL

doi

10.1016/j.fertnstert.2015.10.004

subject

Has Abstract

pub_date

2016-02-01 00:00:00

pages

385-93.e3

issue

2

eissn

0015-0282

issn

1556-5653

pii

S0015-0282(15)02011-7

journal_volume

105

pub_type

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