Abstract
to study AMH level effect on IVF/ICSI cycle outcome in expected poor responders undergoing ART.
retrospective cohort study.
IVF unit at king Abdulaziz medical city, Riyadh, KSA.
258 patients expected to be poor responders according to Bolonga criteria (aged >37or previous poor ovarian response or patients with decreased ovarian reserve) had their serum AMH level obtained and underwent IVF/ICSI cycles between April 2013 to April 2015.
pregnancy and cancellation rates.
patients were divided into three groups according to their AMH level, 60 Patients with AMH level ≤2.8, 98 patients with AMH level 2.9-14.9, and 100 patients with AMH level >15 pmol/l. Patients with lowest AMH had lowest AFC, highest FSH, and lowest number of previous delivery. Lowest AMH patients had lowest number of oocytes collected (p < .0001), lowest pregnancy rate (p = .001), and highest cancellation rate (p < .001).
The receiver operating characteristic (ROC) curve analysis was used to establish the cut-off value for serum AMH level in predicting cancellation of ART cycle. It revealed a cutoff point of 2.8 pmol/L with sensitivity of 85% and specificity of 45% (DeLong SE = 0.04: CI 0.58-0.75). ROC of AMH level and pregnancy prediction showed a cut off point of 16.2 pmol/L with sensitivity 54% and specificity of 66% (DeLong SE = 0.04: CI 0.53-0.69).
Low AMH level in expected poor responders in ART cycles had lower pregnancy rate and higher cancellation rate.