Prognostic indicators of assisted reproduction technology outcomes of cycles with ultralow serum antimüllerian hormone

a multivariate analysis of over 5,000 autologous cycles from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System database for 2012-2013

David Seifer, Oded Tal, Ethan Wantman, Preeti Edul, Valerie L. Baker

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

OBJECTIVE: To assess cycle outcomes when antimüllerian hormone (AMH) is ultralow (≤0.16 ng/mL) and to determine which parameters contribute to the probability of cycle cancellation and/or outcome.

DESIGN: Retrospective analysis.

SETTING: Not applicable.

PATIENT(S): 5,087 (7.3%) fresh and 243 (1.5%) thawed cycles with ultralow AMH values.

INTERVENTION(S): Linear and logistic regression, comparison with age-matched cycles with normal AMH concentrations.

MAIN OUTCOME MEASURE(S): Cancellation rate; number of retrieved oocytes, embryos, transferred embryos, and cryopreserved embryos; clinical pregnancy, live-birth, and multiple birth rates.

RESULT(S): The total cancellation rate per cycle start for fresh cycles was 54%. Of these, 38.6% of the cycles were canceled before retrieval, and 3.3% of cycles obtained no oocytes at time of retrieval. Of all retrieval attempts, 50.7% had three oocytes or fewer retrieved, and 25.1% had no embryo transfer. The live-birth rates were 9.5% per cycle start. Cycles with ultralow AMH levels compared with age-matched normal AMH cycles demonstrated more than a fivefold greater pre-retrieval cancellation rate, a twofold less live-birth rate per cycle and a 4.5-fold less embryo cryopreservation rate.

CONCLUSION(S): Refusing treatment solely on the basis of ultralow AMH levels is not advisable, but patients should be counseled appropriately about the prognostic factors for cancellation and outcomes.

Original languageEnglish (US)
Pages (from-to)385-393
Number of pages9
JournalFertility and Sterility
Volume105
Issue number2
DOIs
StatePublished - Feb 1 2016

Fingerprint

Assisted Reproductive Techniques
Reproduction
Multivariate Analysis
Databases
Hormones
Technology
Birth Rate
Live Birth
Embryonic Structures
Serum
Oocytes
Multiple Birth Offspring
Embryo Transfer
Cryopreservation
Linear Models
Logistic Models
Pregnancy

Keywords

  • AMH
  • ART outcomes
  • low AMH
  • multiple births
  • prognostic factors
  • ultralow AMH

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{60e72dadd74f4868bcf0ea836ab2bf8e,
title = "Prognostic indicators of assisted reproduction technology outcomes of cycles with ultralow serum antim{\"u}llerian hormone: a multivariate analysis of over 5,000 autologous cycles from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System database for 2012-2013",
abstract = "OBJECTIVE: To assess cycle outcomes when antim{\"u}llerian hormone (AMH) is ultralow (≤0.16 ng/mL) and to determine which parameters contribute to the probability of cycle cancellation and/or outcome.DESIGN: Retrospective analysis.SETTING: Not applicable.PATIENT(S): 5,087 (7.3{\%}) fresh and 243 (1.5{\%}) thawed cycles with ultralow AMH values.INTERVENTION(S): Linear and logistic regression, comparison with age-matched cycles with normal AMH concentrations.MAIN OUTCOME MEASURE(S): Cancellation rate; number of retrieved oocytes, embryos, transferred embryos, and cryopreserved embryos; clinical pregnancy, live-birth, and multiple birth rates.RESULT(S): The total cancellation rate per cycle start for fresh cycles was 54{\%}. Of these, 38.6{\%} of the cycles were canceled before retrieval, and 3.3{\%} of cycles obtained no oocytes at time of retrieval. Of all retrieval attempts, 50.7{\%} had three oocytes or fewer retrieved, and 25.1{\%} had no embryo transfer. The live-birth rates were 9.5{\%} per cycle start. Cycles with ultralow AMH levels compared with age-matched normal AMH cycles demonstrated more than a fivefold greater pre-retrieval cancellation rate, a twofold less live-birth rate per cycle and a 4.5-fold less embryo cryopreservation rate.CONCLUSION(S): Refusing treatment solely on the basis of ultralow AMH levels is not advisable, but patients should be counseled appropriately about the prognostic factors for cancellation and outcomes.",
keywords = "AMH, ART outcomes, low AMH, multiple births, prognostic factors, ultralow AMH",
author = "David Seifer and Oded Tal and Ethan Wantman and Preeti Edul and Baker, {Valerie L.}",
year = "2016",
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T1 - Prognostic indicators of assisted reproduction technology outcomes of cycles with ultralow serum antimüllerian hormone

T2 - a multivariate analysis of over 5,000 autologous cycles from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System database for 2012-2013

AU - Seifer, David

AU - Tal, Oded

AU - Wantman, Ethan

AU - Edul, Preeti

AU - Baker, Valerie L.

PY - 2016/2/1

Y1 - 2016/2/1

N2 - OBJECTIVE: To assess cycle outcomes when antimüllerian hormone (AMH) is ultralow (≤0.16 ng/mL) and to determine which parameters contribute to the probability of cycle cancellation and/or outcome.DESIGN: Retrospective analysis.SETTING: Not applicable.PATIENT(S): 5,087 (7.3%) fresh and 243 (1.5%) thawed cycles with ultralow AMH values.INTERVENTION(S): Linear and logistic regression, comparison with age-matched cycles with normal AMH concentrations.MAIN OUTCOME MEASURE(S): Cancellation rate; number of retrieved oocytes, embryos, transferred embryos, and cryopreserved embryos; clinical pregnancy, live-birth, and multiple birth rates.RESULT(S): The total cancellation rate per cycle start for fresh cycles was 54%. Of these, 38.6% of the cycles were canceled before retrieval, and 3.3% of cycles obtained no oocytes at time of retrieval. Of all retrieval attempts, 50.7% had three oocytes or fewer retrieved, and 25.1% had no embryo transfer. The live-birth rates were 9.5% per cycle start. Cycles with ultralow AMH levels compared with age-matched normal AMH cycles demonstrated more than a fivefold greater pre-retrieval cancellation rate, a twofold less live-birth rate per cycle and a 4.5-fold less embryo cryopreservation rate.CONCLUSION(S): Refusing treatment solely on the basis of ultralow AMH levels is not advisable, but patients should be counseled appropriately about the prognostic factors for cancellation and outcomes.

AB - OBJECTIVE: To assess cycle outcomes when antimüllerian hormone (AMH) is ultralow (≤0.16 ng/mL) and to determine which parameters contribute to the probability of cycle cancellation and/or outcome.DESIGN: Retrospective analysis.SETTING: Not applicable.PATIENT(S): 5,087 (7.3%) fresh and 243 (1.5%) thawed cycles with ultralow AMH values.INTERVENTION(S): Linear and logistic regression, comparison with age-matched cycles with normal AMH concentrations.MAIN OUTCOME MEASURE(S): Cancellation rate; number of retrieved oocytes, embryos, transferred embryos, and cryopreserved embryos; clinical pregnancy, live-birth, and multiple birth rates.RESULT(S): The total cancellation rate per cycle start for fresh cycles was 54%. Of these, 38.6% of the cycles were canceled before retrieval, and 3.3% of cycles obtained no oocytes at time of retrieval. Of all retrieval attempts, 50.7% had three oocytes or fewer retrieved, and 25.1% had no embryo transfer. The live-birth rates were 9.5% per cycle start. Cycles with ultralow AMH levels compared with age-matched normal AMH cycles demonstrated more than a fivefold greater pre-retrieval cancellation rate, a twofold less live-birth rate per cycle and a 4.5-fold less embryo cryopreservation rate.CONCLUSION(S): Refusing treatment solely on the basis of ultralow AMH levels is not advisable, but patients should be counseled appropriately about the prognostic factors for cancellation and outcomes.

KW - AMH

KW - ART outcomes

KW - low AMH

KW - multiple births

KW - prognostic factors

KW - ultralow AMH

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U2 - 10.1016/j.fertnstert.2015.10.004

DO - 10.1016/j.fertnstert.2015.10.004

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VL - 105

SP - 385

EP - 393

JO - Fertility and Sterility

JF - Fertility and Sterility

SN - 0015-0282

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