Definition by FSH, AMH and embryo numbers of good-, intermediate- and poor-prognosis patients suggests previously unknown IVF outcome-determining factor associated with AMHReport as inadecuate




Definition by FSH, AMH and embryo numbers of good-, intermediate- and poor-prognosis patients suggests previously unknown IVF outcome-determining factor associated with AMH - Download this document for free, or read online. Document in PDF available to download.

Journal of Translational Medicine

, 14:172

Clinical translation

Abstract

BackgroundThough outcome models have been proposed previously, it is unknown whether cutoffs in clinical pregnancy and live birth rates at all ages are able to classify in vitro fertilization IVF patients into good-, intermediate- and poor prognosis.

MethodsWe here in 3 infertile patient cohorts, involving 1247, 1514 and 632 women, built logistic regression models based on 3 functional ovarian reserve FOR parameters, including 1 number of good quality embryos, 2 follicle stimulating hormone FSH, mIU-mL and 3 anti-Müllerian hormone AMH, ng-mL, determining whether clinical pregnancy and live birth rates can discriminate between good, intermediate and poor prognosis patients.

ResultsAll models, indeed, allowed at all ages for separation by prognosis, though cut offs changed with age. In the embryo model, increasing embryo production resulted in linear improvement of IVF outcomes despite transfer of similar embryo numbers; in the FSH model outcomes and FSH levels related inversely, while the association of AMH followed a bell-shaped polynomial pattern, demonstrating -best- outcomes at mid-ranges. All 3 models demonstrated increasingly poor outcomes with advancing ages, though -best- AMH even above age 43 was still associated with unexpectedly good pregnancy and delivery outcomes. Excessively high AMH, in contrast, was at all ages associated with spiking miscarriage rates.

ConclusionsAt varying peripheral serum concentrations, AMH, thus, demonstrates hithero unknown and contradictory effects on IVF outcomes, deserving at different concentrations investigation as a potential therapeutic agent, with pregnancy-supporting and pregnancy-interrupting properties.

KeywordsIn vitro fertilization IVF Prognosis Live birth rates Prediction models Anti-Müllerian hormone AMH Follicle stimulating hormone FSH Embryo number AbbreviationsAMHanti-Müllerian hormone

DHEAdehydroepiandrosterone

FORfunctional ovarian reserve

FSHfollicle stimulating hormone

hCGhuman chorionic gonadotropin

hMGhuman menopausal gonadotropin

IVFin vitro fertilization

LFORlow functional ovarian reserve

oPOIoccult primary ovarian insufficiency

PGSpreimplantation genetic screening

POApremature ovarian aging

POIprimary ovarian insufficiency

Electronic supplementary materialThe online version of this article doi:10.1186-s12967-016-0924-7 contains supplementary material, which is available to authorized users.

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Author: Norbert Gleicher - Vitaly A. Kushnir - Aritro Sen - Sarah K. Darmon - Andrea Weghofer - Yan-Guang Wu - Qi Wang - Lin Zha

Source: https://link.springer.com/







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