In women, AMH levels may represent the ovarian follicular pool and could be a useful marker of ovarian reserve. The clinical application of AMH measurement has been proposed in the prediction of quantitative and qualitative aspects. Indeed, several authors have found a significant positive correlation between serum AMH levels and oocyte quality. However, this relationship is still controversial. Since serum AMH levels are strongly dependent on age, it is necessary to take it into consideration in analyzing them. Therefore in this study, we stratified ART cycles according to age and serum AMH levels, and analyzed the indicators of oocyte quality in order to clarify the relationship between them.
【DESIGN】 Retrospective analysis
【MATERIALS AND METHODS】
We collected a total of 2950 ART cycles from 1689 women undergoing ART treatment who attended our ART center between January 2010 and December 2010. At first, the cycles were divided into four groups according to age: (A) -29, (B) 30-34, (C) 35-39, (D) 40-. The distribution profile of serum AMH levels among them was calculated and each group was subdivided into three groups according to relative serum AMH levels in the group: (a) more than 75 percentile, (b)25-75 percentile, (c) less than 25 percentile. The number of retrieved oocytes, the percentage of 2PN oocytes, the percentage of normal cleaved embryos, the development of high quality embryos on day 2, the blastocyst formation rate on day 5, and the high quality blastocyst rate on day 5 were examined and compared in each group.
The indicators of oocyte quality tend to be poorer in low serum AMH cycles. Among them, especially the high quality blastocyst rate on day 5 was significantly lower in low serum AMH groups (as shown below).
In this study, we showed that the lower serum AMH levels, when stratified by age, are associated with the poorer oocyte quality. Serum AMH levels could be a good predictive marker for the qualitative outcome in ART.