The effect of anti-mullerian hormone for prediction of oocyte and improving pregnancy under ART

Background: Infertility has many potential causes, which may involve the man, the woman or both partners. In some cases, no cause of the problem can be determined, in which case the infertility is described as unexplained. Infertility can be distressing and devastating for many people. They will experience stress, sadness, or feelings of hopelessness. Clinical knowledge and advancement in technology has been helpful for infertility via Assisted Reproductive Techniques (ART). National guidelines and national registries for (ART) are becoming more widespread and are expected to play an important role in promoting best practice in ART in the future. Anti Mullerian Hormone (AMH) is one of the most accurate tests to assess a woman s ovarian reserve and is produced by the medium sized immature eggs in the ovaries. It is a powerful test because it gives an indication of likely menopausal age, likely reproductive time frame and likely response to drugs in an IVF cycle (how many eggs you are likely to get). AMH also can be used to confirm polycystic ovary syndrome and gives a guide to egg quality. However what AMH cannot tell you is whether you are going to have a baby.Objective: To determine effects of Anti-Mullerian Hormone on the variables M2 (Metaphase II), 2PN (two pronucleia), Maturation rate oocyte and pregnancy rate in infertile women under Assisted Reproductive Technology (ART) (IVF, ICSI).Materials and Methods: A sample of 1000 participants collected at Yazd Research and Clinical Center for Infertility, Yazd, Iran, from April 2016 to February 2017. The participants were divided into three groups of AMH (1: less than 1 ng/ml, 2: between 1 and 3.5 ng/ml 3: and greater than 3.5 ng/ml). Analysis was done by Chi-square, independent t test, ANOVA test and logistic regression.Results: A two sample t test results shows that the mean age of women 29.5±5.0 for pregnancy is significantly lower than 31.50±5.8 for non-pregnancy (p<0.001). There is a statistically significant difference (p<0.001) between the three groups of AMH for the variables M2, Maturation rate oocyte and 2PN. Logistic regression of clinical pregnancy showed significant effect on AM (2 vs. 1, OR=1.51, CI (0.83, 2.76), 3 vs. 1, OR=3.06, CI (1.68, 5.56)) Fertilization (1 vs. 2, OR=1.56, CI (1.06, 2.31), 1 vs. 3, OR=1.83, CI (1.25, 2.70)) Female age OR=0.96, CI (0.93, 0.99). The Chi-square test revealed, the proportion of pregnancy tended to differ across AMH group (p<0.01).Conclusion: Our analysis of data shows the higher level AMH on M2, TwoPN, Maturation rate oocyte is better prediction of the clinical pregnancy rate in infertile women. The Logistic regression also provide the evidence of prediction of clinical pregnancy rate on AMH, Fertilization ،Female age.

Keywords:

Pregnancy rate , Assisted Reproductive Technology