Journal of Reproduction & Infertility

Journal of Reproduction & Infertility

The Association of AMH Level with the Number and Quality of Oocytes in Women Undergoing IVF/ICSI: A Single-Center Study

Authors
Zohreh Heidary 1
Masoumeh Masoumi 1
Mohadese Dashtkoohi 1
Niusha Sharifinejad 2
Masoumeh Dehghan Tarzjani 1
Marjan Ghaemi 1
Batool Hossein Rashidi 1
1 Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
2 Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
10.18502/jri.v25i1.15197
Abstract
Background: The recognized role of Anti-Müllerian hormone (AMH) as a marker for women's biological age and ovarian reserve prompts debate on its efficacy in predicting oocyte quality during IVF/ICSI. Recent findings challenging this view compelled us to conduct this study to examine the correlation between AMH levels and quantity/quality of oocytes in IVF/ICSI procedures. Methods: The data were collected retrospectively from the medical records of 320 women between 25-42 years old. The included patients were divided into two groups: the high AMH group (>1.1 ng/ml) and the low AMH (=<1.1 ng/ml) group. The high AMH group comprised 213 patients, while the low AMH group consisted of 107 patients. Spearman's correlation coefficient and Multinomial logistic regression were computed to assess the relationships between different variables. Results: Significant positive correlations were detected between AMH level and the number of aspirated follicles (rho=0.741, p<0.001), retrieved oocytes (rho=0.659, p<0.001), M2 oocytes (rho=0.624, p<0.001), grade A embryos (rho=0.419, p<0.001), and grade AB embryos (rho=0.446, p<0.001. In contrast, AMH levels had negative associations with the number and duration of cycles (p<0.05). AMH emerged as a statistically significant independent predictor of the number of M2 oocytes. Conclusions: Serum AMH level could represent the quantity and quality of oocytes following IVF/ICSI treatments. Future studies should aim to delve deeper into the correlations between AMH levels and both the quality and quantity of embryos. Additionally, it would be beneficial to consider the influence of sperm factors, as well as assess pregnancy rates.
Keywords
anti
Mullerian Hormone
In vitro fertilization
Intracytoplasmic Sperm Injection
Oocytes
Patrizio P, Sakkas D. From oocyte to baby: a clinical evaluation of the biological efficiency of in vitro fertilization. Fertil Steril. 2009;91(4):1061-6.
Farhi J, Cohen K, Mizrachi Y, Weissman A, Raziel A, Orvieto R. Should ICSI be implemented during IVF to all advanced-age patients with non-male factor subfertility? Reprod Biol Endocrinol. 2019;17(1):30.
Cai QF, Wan F, Huang R, Zhang HW. Factors predicting the cumulative outcome of IVF/ICSI treatment: a multivariable analysis of 2450 patients. Hum Reprod. 2011;26(9):2532-40.
Ingilizova G, Ivanov D, Kovachev E, Evrev M, Kostov I, Necheva V. [Oocyte quality as a predictive marker for assessment of IVF/ICSI procedure outcome]. Akush Ginekol (Sofiia). 2014;53(6):41-6.
Li A, Zhang J, Kuang Y, Yu C. Analysis of IVF/ICSI-FET outcomes in women with advanced endometriosis: influence on ovarian response and oocyte competence. Front Endocrinol (Lausanne). 2020;11:427.
Lasiene K, Lasys V, Glinskyte S, Valanciute A, Vitkus A. Relevance and methodology for the morphological analysis of oocyte quality in IVF and ICSI. J Reprod Stem Cell Biotechnol. 2011;2(1):1-13.
Weenen C, Laven JS, Von Bergh AR, Cranfield M, Groome NP, Visser JA, et al. Anti-Müllerian hormone expression pattern in the human ovary: potential implications for initial and cyclic follicle recruitment. Mol Hum Reprod. 2004;10(2):77-83.
Wiweko B, Prawesti DMP, Hestiantoro A, Sumapraja K, Natadisastra M, Baziad A. Chronological age vs biological age: an age-related normogram for antral follicle count, FSH and anti-Mullerian hormone. J Assisted Reprod Genet. 2013;30(12):1563-7.
La Marca A, Stabile G, Artenisio AC, Volpe A. Serum anti-Mullerian hormone throughout the human menstrual cycle. Hum Reprod. 2006;21(12):3103-7.
Broekmans FJ, Faddy MJ, Scheffer G, te Velde ER. Antral follicle counts are related to age at natural fertility loss and age at menopause. Menopause. 2004;11(6 Pt 1):607-14.
Smeenk JM, Sweep FC, Zielhuis GA, Kremer JA, Thomas CM, Braat DD. Antimüllerian hormone predicts ovarian responsiveness, but not embryo quality or pregnancy, after in vitro fertilization or intracyoplasmic sperm injection. Fertil Steril. 2007;87(1):223-6.
Yılmaz T, Tavukçuoğlu Ş, Taşdemir S, Esenkaya S, İrez T. Can follicular fluid anti-mullerian hormone level be a determinant of pregnancy in women under 35 years of age? Int J Womens Health Reprod Sci. 2018;6(1):6-10.
Papas M, Govaere J, Peere S, Gerits I, Van de Velde M, Angel-Velez D, et al. Anti-Müllerian hormone and OPU-ICSI outcome in the mare. Animals (Basel). 2021;11(7):2004.
Morin SJ, Patounakis G, Juneau CR, Neal SA, Scott RT, Seli E. Diminished ovarian reserve and poor response to stimulation in patients <38 years old: a quantitative but not qualitative reduction in performance. Hum Reprod. 2018;33(8):1489-98.
Chang CC, Shapiro D, Toledo AA, Sadruddin S, Wright G, Nagy ZP. Does AMH correlate with oocyte quality obtained from donors? Fertil Steril. 2018;110(4):e228.
Park HJ, Lyu SW, Seok HH, Yoon TK, Lee WS. Anti-Müllerian hormone levels as a predictor of clinical pregnancy in in vitro fertilization/intracytoplasmic sperm injection-embryo transfer cycles in patients over 40 years of age. Clin Exp Reprod Med. 2015;42(4):143-8.
Harris ID, Roth L, Brinker K, McShane P, Wang S, Alvero R. Determining the optimal cut-off value for antimullerian hormone in ovarian reserve testing. Fertil Steril. 2011;96(3):S193.
Zhang JJ, Yang M, Merhi Z. Efficiency of metaphase II oocytes following minimal/mild ovarian stimulation in vitro fertilization. Fertil Res Pract. 2016;2:2.
Tesarik J, Junca AM, Hazout A, Aubriot FX, Nathan C, Cohen-Bacrie P, et al. Embryos with high implantation potential after intracytoplasmic sperm injection can be recognized by a simple, non-invasive examination of pronuclear morphology. Hum Reprod. 2000;15(6):1396-9.
Sun XY, Lan YZ, Liu S, Long XP, Mao XG, Liu L. Relationship between anti-müllerian hormone and in vitro fertilization-embryo transfer in clinical pregnancy. Front Endocrinol (Lausanne). 2020;11:595448.
Zhao D, Fan J, Wang P, Jiang X, Yao J, Li X. Age-specific definition of low anti-Mullerian hormone and associated pregnancy outcome in women undergoing IVF treatment. BMC Pregnancy Childbirth. 2021;21(1):186.
Irez T, Ocal P, Guralp O, Cetin M, Aydogan B, Sahmay S. Different serum anti-Müllerian hormone concentrations are associated with oocyte quality, embryo development parameters and IVF-ICSI outcomes. Arch Gynecol Obstet. 2011;284(5):1295-301.
Park HJ, Lyu SW, Seok HH, Yoon TK, Lee WS. Anti-müllerian hormone levels as a predictor of clinical pregnancy in in vitro fertilization/intracytoplasmic sperm injection-embryo transfer cycles in patients over 40 years of age. Clin Exp Reprod Med. 2015;42(4):143-8.
Lawal OI, Yusuff J-dO. Demographic, lifestyle, and reproductive determinants of serum anti-Müllerian hormone levels in adult women of reproductive age in Ilorin, North-Central Nigeria. Middle East Fertil Soci J. 2021;26(1):23.
Ghomian N, Lotfalizadeh M, Malihe A, Keshtan F. Association between Anti-Mullerian Hormone and Ovarian Response and Pregnancy in Polycystic Ovary Syndrome Patients. Int J Women's Health Reprod Sci. 2018;7:49-53.
Bakhtiari M, Babaei T, Safarpour M, Esmaeili M, Esmaeili M, Asgari R, et al. Investigating the factors affecting the ICSI (microinjection) success in infertile people referred to an infertility treatment center in western Iran from 2011 to 2017. J Obstet Gynecol Cancer Res. 2020;5(3):115-25.
Parsanezhad ME, Jahromi BN, Rezaee S, Kooshesh L, Alaee S. The effect of four different gonadotropin protocols on oocyte and embryo quality and pregnancy outcomes in IVF/ICSI cycles; a randomized controlled trial. Iran J Med Sci. 2017;42(1):57-65.
Yang YC, Li YP, Pan SP, Chao KH, Chang CH, Yang JH, et al. The different impact of stimulation duration on oocyte maturation and pregnancy outcome in fresh cycles with GnRH antagonist protocol in poor responders and normal responders. Taiwan J Obstet Gynecol. 2019;58(4):471-6.
Dai X, Wang Y, Yang H, Gao T, Yu C, Cao F, et al. AMH has no role in predicting oocyte quality in women with advanced age undergoing IVF/ICSI cycles. Sci Rep. 2020;10(1):19750.
Dahan MH, Tannus S. Believing that transferring more embryos will result in increased pregnancy rates: a flawed concept: a SWOT analysis. Middle East Fertil Soci J. 2020;25(1):32.
McLernon DJ, Harrild K, Bergh C, Davies MJ, de Neubourg D, Dumoulin JCM, et al. Clinical effectiveness of elective single versus double embryo transfer: meta-analysis of individual patient data from randomised trials. BMJ. 2010;341:c6945.
Sun TC, Zhou SJ, Song LL, Li JH, Chen X, Tian L. High anti-müllerian hormone levels might not reflect the likelihood of clinical pregnancy rate in IVF/ICSI treatment. JBRA Assist Reprod. 2021;25(2):266-71.
Sahmay S, Oncul M, Tuten A, Tok A, Acıkgoz AS, Cepni I. Anti-müllerian hormone levels as a predictor of the pregnancy rate in women of advanced reproductive age. J Assist Reprod Genet. 2014;31(11):1469-74.
Journal of Reproduction & Infertility
Volume 25, Issue 1
Winter 2024
Pages 38-45