Anti-Mülleryan Hormonun İn Vitro Fertilizasyon Siklus Sonuçlarına Etkisinin Araştırılması

Year 2022, Volume: 24 Issue: 3, 328 - 332, 30.12.2022

Kadriye Erdoğan , Nazlı Tunca Şanlıer , Huri Güvey , Serdar Dilbaz , İnci Kahyaoğlu , Yaprak Ustun

https://doi.org/10.18678/dtfd.1198037

Abstract

Amaç: Bu çalışma, serum anti-Mülleryan hormon (AMH) seviyesinin in vitro fertilizasyon (IVF) siklus sonuçları üzerindeki etkisini araştırmak için yürütülmüştür.
Gereç ve Yöntemler: Bu çalışmaya dahil edilen toplam 142 hasta, serum AMH düzeylerine göre, Grup 1: AMH düzeyi 5-10 ng/mL (n=108), Grup 2: AMH düzeyi 10-15 ng/mL (n=20) ve Grup 3: AMH düzeyi >15 ng/mL (n=14) olmak üzere üç gruba ayrıldı. Demografik özellikler kaydedildi. İnfertilite ve stimülasyon süresi, siklus sayısı, gonadotropinlerin başlangıç, son ve toplam dozları ile tetikleme, oosit toplama (oocyte pick up, OPU) ve embriyo transferi (ET) gününde östradiol (E2) ve progesteron düzeyleri, toplanan toplam oosit sayısı, matur oosit sayısı, embriyo sayısı ve kalitesi ve ayrıca tetikleme, OPU ve ET gününde endometrial kalınlık, embriyo-fundus mesafesi, ET günü ve gebelik sonuçlarının tamamı kaydedildi.
Bulgular: IVF tedavi endikasyonları ve gebelik sonuçları gruplar arasında benzer iken, vücut kitle indeksi (VKİ) Grup 2 ve Grup 3'te Grup 1'e göre anlamlı olarak daha yüksekti (p<0,001). Toplam gonadotropin dozları Grup 2'de Grup 1 ve Grup 3’e göre anlamlı olarak daha yüksek ve toplam oosit sayısı da Grup 3'te Grup 1'e göre anlamlı olarak daha yüksek idi (sırasıyla, p=0,006 ve p=0,015).
Sonuç: AMH seviyesi VKİ ve toplam oosit sayısı ile ilişkilidir, fakat matur oosit sayısı, oosit kalitesi ve gebelik sonuçları ile ilişkili değildir.

Keywords

AMH seviyeleri, IVF siklus sonuçları, VKİ, oosit sayısı ve kalitesi, gebelik sonuçları

Evaluation of Anti-Mullerian Hormone in Predicting In Vitro Fertilization Cycle Outcomes

Abstract

Aim: This study was conducted to explore the effect of serum anti-Mullerian hormone (AMH) level on in vitro fertilization (IVF) cycle outcomes.
Material and Methods: A total of 142 patients included in this study, were divided into three groups according to their serum AMH levels as Group 1: AMH level 5-10 ng/ml (n=108), Group 2: AMH level 10-15 ng/ml (n=20), and Group 3: AMH level >15 ng/ml (n=14). Demographic characteristics were recorded. The duration of infertility and stimulation, the number of cycles, initial, final, and total doses of gonadotropins, and estradiol (E2) and progesterone levels on the day of trigger, oocyte pick up (OPU) and embryo transfer (ET), the total number of oocytes retrieved, the number of mature oocytes, the number and quality of the embryo, and also endometrial thickness on the day of trigger, OPU and ET, the distance of embryo-fundus, the day of ET, and pregnancy outcomes were all recorded.
Results: While the IVF treatment indications and pregnancy outcomes were similar between the groups, body mass index (BMI) was significantly higher in Group 2 and Group 3 than in Group 1 (p<0.001). The total doses of gonadotropin were significantly higher in Group 2 than in Group 1 and Group 3, and the total oocyte count was also significantly higher in Group 3 than in Group 1 (p=0.006, and p=0.015, respectively)
Conclusion: AMH levels were associated with BMI and total oocyte count, but not with mature oocyte count, oocyte quality, and pregnancy outcomes.

Keywords

AMH levels, IVF cycle outcomes, BMI, oocyte count and quality, pregnancy outcomes

References

• di Clemente N, Racine C, Pierre A, Taieb J. Anti-Müllerian hormone in female reproduction. Endocr Rev. 2021;42(6):753-82.
• Moolhuijsen LME, Visser JA. Anti-Müllerian hormone and ovarian reserve: update on assessing ovarian function. J Clin Endocrinol Metab. 2020;105(11):3361-73.
• Arce JC, La Marca A, Mirner Klein B, Nyboe Andersen A, Fleming R. Antimüllerian hormone in gonadotropin releasing-hormone antagonist cycles: prediction of ovarian response and cumulative treatment outcome in good-prognosis patients. Fertil Steril. 2013;99(6):1644-53.
• Choi MH, Yoo JH, Kim HO, Cha SH, Park CW, Yang KM, et al. Serum anti-Müllerian hormone levels as a predictor of the ovarian response and IVF outcomes. Clin Exp Reprod Med. 2011;38(3):153-8.
• Morales HSG, López GGP, Cortés DV, Torres GCR, Hernández HS, Guiot ML, et al. Evaluation of the anti-Müllerian hormone and its association with embryo quality in advanced reproductive treatments in a Latin American Population. JBRA Assist Reprod. 2022;26(1):50-2.
• Sun TC, Zhou SJ, Song LL, Li JH, Chen X, Tian L. High anti-Müllerian hormone levels might not reflect the likelihood of clinical pregnancy rate in IVF/ICSI treatment. JBRA Assist Reprod. 2021;25(2):266-71.
• Korkidakis A, Cho KK, Albert A, Au J, Mellon J, Dunne CM. Anti-Müllerian hormone and embryo quality as determined by time-lapse imaging. Minerva Ginecol. 2020;72(3):132-7.
• Stracquadanio M, Ciotta L, Palumbo MA. Relationship between serum anti-Mullerian hormone and intrafollicular AMH levels in PCOS women. Gynecol Endocrinol. 2018;34(3):223-8.
• von Wolff M, Mitter VR, Jamir N, Stute P, Eisenhut M, Bersinger NA. The endocrine milieu in naturally matured follicles is different in women with high serum anti-Müllerian hormone concentrations. Reprod Biomed Online. 2021;43(2):329-37.
• Alpha Scientists in Reproductive Medicine and ESHRE Special Interest Group of Embryology. The Istanbul consensus workshop on embryo assessment: proceedings of an expert meeting. Hum Reprod. 2011;26(6):1270-83.
• Pacchiarotti A, Selman H, Valeri C, Napoletano S, Sbracia M, Antonini G, et al. Ovarian stimulation protocol in IVF: An up-to-date review of the literature. Curr Pharm Biotechnol. 2016;17(4):303-15.
• Grimes NP, Whitcomb BW, Reeves KW, Sievert LL, Purdue-Smithe A, Manson JE, et al. The association between anthropometric factors and anti-Müllerian hormone levels in premenopausal women. Women Health. 2022;62(7):580-92.
• Oldfield AL, Kazemi M, Lujan ME. Impact of obesity on anti-Mullerian hormone (AMH) levels in women of reproductive age. J Clin Med. 2021;10(14):3192.
• Park HT, Cho GJ, Ahn KH, Shin JH, Kim YT, Hur JY, et al. Association of insulin resistance with anti-Mullerian hormone levels in women without polycystic ovary syndrome (PCOS). Clin Endocrinol (Oxf). 2010;72(1):26-31.
• Jaswa EG, Rios JS, Cedars MI, Santoro NF, Pavone MEG., Legro RS, et al. Increased body mass index is associated with a nondilutional reduction in Antimüllerian hormone. J Clin Endocrinol Metab. 2020;105(10):3234-42.
• Bolat SE, Ozdemirci S, Kasapoglu T, Duran B, Goktas L, Karahanoglu E. The effect of serum and follicular fluid anti-Mullerian hormone level on the number of oocytes retrieved and rate of fertilization and clinical pregnancy. North Clin Istanb. 2016;3(2):90-6.
• Garcia-Velasco JA, Moreno L, Pacheco A, Guillén A, Duque L, Requena A, et al. The aromatase inhibitor letrozole increases the concentration of intraovarian androgens and improves in vitro fertilization outcome in low responder patients: a pilot study. Fertil Steril. 2005;84(1):82-7.
• Grossman MP, Nakajima ST, Fallat ME, Siow Y. Müllerian-inhibiting substance inhibits cytochrome P450 aromatase activity in human granulosa lutein cell culture. Fertil Steril. 2008;89 (5 Suppl):1364-70.
• Lie Fong S, Baart EB, Martini E, Schipper I, Visser JA, Themmen AP, et al. Anti-Müllerian hormone: a marker for oocyte quantity, oocyte quality and embryo quality? Reprod Biomed Online. 2008;16(5):664-70.
• Acharya KS, Harris BS, Weber JM, Truong T, Pieper C, Eaton JL. Impact of increasing antimüllerian hormone level on in vitro fertilization fresh transfer and live birth rate. F S Rep. 2022;3(3):223-30.
• Wang J, Dicken C, Lustbader JW, Tortoriello DV. Evidence for a Mullerian-inhibiting substance autocrine/paracrine system in adult human endometrium. Fertil Steril. 2009;91(4):1195-203.
• Kaya C, Pabuccu R, Satiroglu H. Serum antimullerian hormone concentrations on day 3 of the in vitro fertilization stimulation cycle are predictive of the fertilization, implantation, and pregnancy in polycystic ovary syndrome patients undergoing assisted reproduction. Fertil Steril. 2010;94(6):2202-7.