When AMH and FSH levels conflict, which better predicts IVF outcomes?

  • Ligon S & al.
  • Fertil Steril
  • 2 May 2019

  • International Clinical Digest
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Takeaway

  • Anti-Müllerian hormone (AMH) levels are a better predictor of live birth rate than follicle-stimulating hormone (FSH) levels when test results are discordant in women undergoing in vitro fertilization (IVF).

Why this matters

  • FSH and AMH levels are discordant in 20%-43% of patients, and their relative utility for live birth prediction is controversial.

Key results

  • In the overall cohort, the live birth rate was 38%.
  • In patients with low AMH and normal FSH (n=6611), the live birth rate was 26%, whereas in patients with normal AMH and elevated FSH (n=4374), the live birth rate was 39% (P<.001>
  • Patients with low AMH/normal FSH had greater IVF cycle cancellation rates compared with patients with normal AMH/elevated FSH (19% vs 8%; P<.001>
  • In patients with normal FSH, low AMH was associated with reduced live birth (relative risk, 0.87; P<.001 compared with normal amh in multivariate analysis.>

Study design

  • 44,696 patients who underwent fresh embryo transfer were analyzed for live birth rates and associated factors.
  • Elevated FSH was defined as >10 mIU/mL, whereas low AMH was defined as
  • Funding: None disclosed.

Limitations

  • Retrospective study.