Women considering or undergoing in vitro fertilization (IVF) received some important news from a study recently published online in the Journal of Clinical Endocrinology & Metabolism. The study found that women with high blood levels of anti-mullerian hormone (AMH) are more likely to have a successful birth following IVF than women of similar age with low levels of the hormone. Previous studies had shown that AMH levels can be indicative of how many eggs remain in a woman's ovaries, but this study is the first to show that high levels of the hormone can indicate the likelihood of a successful pregnancy and birth, regardless of the number of eggs retrieved during the IVF procedure.
AMH is made by small follicles in each ovary and helps regulate the follicles' growth. Each follicle contains an oocyte, a cell from which an egg develops. AMH levels remain low in females until puberty, after which levels rise significantly. The hormone begins to decline during a woman’s reproductive years and is usually not detectable after menopause.
A blood test is used to measure AMH levels. Women of childbearing age may have an AMH test ordered along with other hormone tests, such as estradiol and FSH, to estimate the remaining time left to conceive (known as ovarian reserve). These tests are also useful in evaluating ovarian function and possibly in predicting the onset of menopause. AMH can also be elevated in a woman with polycystic ovarian syndrome (PCOS) and may be used to evaluate this condition.
Researchers from Sweden published a prospective study conducted between 2008 and 2011 of 892 women with a median age of 36 who had IVF. The participants underwent a total of 1,230 IVF cycles. After determining AMH levels through blood samples before IVF, the researchers divided the participants into 3 groups:
- AMH levels lower than 0.84 ng/mL
- AMH levels between 0.84 and 2.94 ng/mL
- AMH levels higher than 2.94 ng/mL
After controlling for both age and number of eggs retrieved, the researchers discovered that AMH levels were a significant predictor of both pregnancy rate and live birth rate. Those women in the study who had AMH levels above 2.94 ng/mL had the highest birth rates. The researchers also found that women with PCOS, which is linked to ovulation problems, are actually good candidates for IVF as they often have both high levels of AMH and of eggs remaining in their ovaries.
"For women who are struggling to get pregnant, a high AMH level should be very reassuring," said Thomas Brodin, MD, of Uppsala University in Sweden and lead author of the study. "High levels of this hormone mean there is a greater chance they have plenty of healthy eggs remaining to support a pregnancy."
The researchers concluded that AMH might be useful as a prognostic factor for determining the chances of successful pregnancy and live birth following IVF, providing additional information that could aid those who are struggling with infertility.
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Brodin,T et al. Antimüllerian Hormone Levels Are Strongly Associated with Live-Birth Rates After Assisted Reproduction. J Clin Endocrinol Metabol. Published online February 13, 2013. Abstract available online at http://jcem.endojournals.org/content/early/2013/02/13/jc.2012-3676.abstract through http://jcem.endojournals.org. Accessed March 2013.
The Endocrine Society. News Room: Anti-Mullerian Hormone Predicts IVF Success. Available online at http://www.endo-society.org/media/press/2013/Anti-Mullerian-Hormone-Predicts-IVF-Success.cfm through http://www.endo-society.org. Accessed March 2013.
Hand, L. Antimüllerian Hormone Level Predicts IVF Success. Available online at http://www.medscape.com/viewarticle/779410 through http://www.medscape.com. Accessed March 2013.