A comparative study on the results of agonist andantagonist protocols based on serum AMH levels inpatients undergoing intracytoplasmic sperm injection

Background: Serum concentrations of antimullerian hormone (AMH) correlatewith ovarian response during assisted reproduction treatment (ART) cycles.Objective: This retrospective study attempted to evaluate the selection of ovarianstimulation protocols based on serum AMH levels in patients and its impact on theresults of ART.Materials and Methods: Based on AMH levels, the patients with tubal factorinfertility were divided in three groups of normal, low and high AMH levels.Oocyte, good embryo number and pregnancy rate in each group were analyzed.Results: Using agonist and antagonist protocols, an increase in serum AMH led tohigher number of oocytes and better quality embryos. At all low, normal and highAMH levels, the agonist protocol led to a more significant increase in the number ofoocytes than the antagonist protocol (p<0.05). The number of high quality embryossignificantly increased by the agonist protocol than antagonist protocol in womenwith normal AMH levels of 1.3-2.6 ng/ml (p=0.00). Moreover, the results for thenumber of high quality embryos at AMH ˃2.6 ng/ml was in favor of the antagonistprotocol (p=0.00). The results showed the lowest pregnancy rate at AMH ˂1.3ng/ml. At AMH ˃2.6 ng/ml, there was a significant increase in pregnancy ratethrough the antagonist protocol (p=0.04).Conclusion: Findings of this study suggested that the ART results are predictable,taking into account the AMH levels. The protocol specific to each patient can beused given the AMH level in each individual. This is because the results of eachprotocol depend on individual conditions

Keywords:

AMH , Ovarian stimulation protocols , Oocyte , Embryo , Pregnancy rate