Serum anti-Müllerian hormone levels predict ICSI outcomes

The number of oocytes retrieved for intracytoplasmic sperm injection (ICSI) is strongly associated with midluteal, early follicular, and ovulatory anti-Müllerian hormone (AMH) levels, Egyptian researchers have discovered.

Dahlia El-Haieg and colleagues from the University of Zagazig, measured AMH, follicle-stimulating hormone (FSH), and leuteinizing hormone levels, and conducted ultrasound evaluation, during the menstrual cycle of 33 patients undergoing their first ICSI treatment cycle.

Nine women had a poor response to ICSI. The number of oocytes retrieved from normal and poor responders was 9.4 and 3.0, respectively.

AMH levels were significantly lower in poor than normal responders in both the ovulatory and midluteal phases. The number of oocytes retrieved positively correlated with midluteal AMH, day 3 AMH, and ovulatory AMH levels, as well as antral follicle counts and average ovarian volume. Day 3 FSH levels negatively correlated with the number of oocytes retrieved.

Poor response was predicted by midluteal, day 3, and ovulatory AMH levels, with areas under the receiver operating characteristics curves of 0.977, 0.900, and 0.980, respectively. Midluteal and early AMH also significantly predicted clinical pregnancy.

"Midluteal and early follicular AMH may offer a better prognostic value for clinical pregnancy than other currently available markers of assisted reproductive technology outcomes," the team concludes.