Association Between Anti-Müllerian Hormone Levels and Intrauterine Insemination Outcomes Across Different Ovarian Stimulation Protocols

Background & Objective: Intrauterine Insemination (IUI) is a commonly used treatment of infertility. Anti-Müllerian Hormone (AMH), produced by growing ovarian follicles, is a reliable marker of ovarian reserve. This study was conducted with aim to investigate the association between AMH levels and pregnancy outcomes in women undergoing IUI with ovarian stimulation.Materials & Methods: This retrospective study was conducted on ۱۰۴ infertile patients undergoing IUI at Dr. Hasan Sadikin Hospital, Bandung, from ۲۰۱۷ to ۲۰۲۱. Eligible women had age ۲۰-۳۵ years with unexplained infertility, mild endometriosis, or mild male factor infertility, and at least one patent fallopian tube. Natural cycle IUI and incomplete records were excluded. AMH levels were measured at cycle start and stratified into five categories: <۱, ۱-۲, ۲-۳, ۳-۵, and >۵ ng/mL. Stimulation protocols included Clomiphene Citrate (CC), recombinant Follicle-Stimulating Hormone (rFSH), or a combination. Clinical pregnancy was confirmed by serum β-hCG ۱۴ days after IUI. Data was analyzed using SPSS software (version ۲۶.۰) and Chi-square test. P<۰.۰۵ was considered significant.Results: The overall clinical pregnancy rate was ۳۶.۵%. A significant association was found between AMH levels and pregnancy outcome in the rFSH group (P=۰.۰۳۶) and the CC + rFSH group (P=۰.۰۲۶), with higher AMH correlated with increased pregnancy rates. No significant association was observed in the CC-only group (P=۰.۶۱۳).Conclusion: AMH level may serve as a useful predictor of IUI success in gonadotropin-containing protocols but appears less predictive in CC-only cycles.

Keywords:

Anti-Müllerian Hormone , Intrauterine Insemination , ovarian stimulation , Follicle-Stimulating Hormone , clomiphene citrate