Anti-Mullerian hormone-based approach to controlled ovarian stimulation for assisted conception

Nelson, S. , Yates, R.W., Lyall, H., Jamieson, M., Traynor, I., Gaudoin, M., Mitchell, P., Ambrose, P. and Fleming, R. (2009) Anti-Mullerian hormone-based approach to controlled ovarian stimulation for assisted conception. Human Reproduction, 24(4), pp. 867-875. (doi:10.1093/humrep/den480)

Full text not currently available from Enlighten.

Publisher's URL: http://www.oxfordjournals.org/

Abstract

BACKGROUND Individualization of controlled ovarian stimulation (COS) for assisted conception is complicated by variable ovarian response to follicle stimulating hormone. We hypothesized that anti-Müllerian hormone (AMH), a predictor of oocyte yield, may facilitate treatment strategies for women undergoing COS, to optimize safety and clinical pregnancy rates.

METHODS Prospective cohort study of 538 patients in two centres with differential COS strategies based on a centralized AMH measurement.

RESULTS AMH was associated with oocyte yield after ovarian stimulation in both centres, and a ‘reduced’ AMH (1 to <5 pmol/l) was associated with a reduced clinical pregnancy rate. Women with a ‘normal’ AMH (5 to <15 pmol/l) treated with a long GnRH-agonist protocol (both centres) showed a low incidence of excess response (0%) and poor response (0%). In women with ‘high’ AMH (>15 pmol/l), the antagonist protocol eliminated the need for complete cryopreservation of embryos due to excess response (P < 0.001) and showed a higher fresh cycle clinical pregnancy rate than agonist cycles [OR 4.40 (95% CI 1.95–9.93), P < 0.001].

CONCLUSIONS The use of circulating AMH to individualize treatment strategies for COS may result in reduced clinical risk, optimized treatment burden and maintained pregnancy rates, and is worthy of prospective randomized examination.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Nelson, Professor Scott and Lyall, Dr Helen and Gaudoin, Dr Marco and Fleming, Professor Richard
Authors: Nelson, S., Yates, R.W., Lyall, H., Jamieson, M., Traynor, I., Gaudoin, M., Mitchell, P., Ambrose, P., and Fleming, R.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Clinical Specialities
Journal Name:Human Reproduction
Publisher:Oxford University Press
ISSN:0268-1161
ISSN (Online):1460-2350
Published Online:10 January 2009

University Staff: Request a correction | Enlighten Editors: Update this record