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- W1980929615 abstract "OBJECTIVE: Anti-Müllerian hormone (AMH) is increasingly a tool of ovarian reserve assessment, exceeding follicle stimulating hormone (FSH) in specificity. It, however, loses predictive value at very low levels. Whether very low AMH levels can discriminate who may, or may not, conceive and should, or should not, be treated was investigated. DESIGN: Cohort study. MATERIALS AND METHODS: Of 249 consecutive women with initial AMH ≤ 1.2ng/ml and (diminished ovarian reserve, DOR) during 2007/8, 229 qualified for analysis. They were divided into AMH <0.1 ng/ml; 0.11-0.4 ng/ml; 0.41-0.8 ng/ml; 0.81-1.2 ng/ml and pregnancy rates were determined. Since most women received dehydroepiandrosterone (DHEA), data do not reflect unsupplemented patients. RESULTS: Mean age 37.0 ± 5.6 years; mean BMI 25.7 ±6.4. Confirming DOR, mean follicle stimulating hormone (FSH) was 12.5 mIU/mL (95% CI 11.0-14.1); mean AMH 0.3 ng/mL (95% CI 0.3-0.4). 181 (73.3%) of patients were Caucasian, 32 (13.0% African American and 34 (13.8%) Asian. Independent of time and length of treatment, 19 women (9.5%) had conceived by time of analysis. Pregnancies occurred at all AMH levels, but likelihood of pregnancy was below 5% at AMH ≤ 0.4 ng/ml, and increased significantly (p =0.01) between 0.41-0.80 ng/mL and again (p=0.001) at AMH 0.81-1.2 ng/mL. Women who conceived had significantly higher AMH levels than those who did not (p=0.001). CONCLUSIONS: AMH, indeed, loses predictive value at low levels. Pregnancies occur even in absence of detectable AMH. Chances are, however, low at AMH under 0.4 ng/ml. AMH, thus, does not allow discrimination between who should, or should not, be entered into fertility treatment. While encouraging treatment attempts at even very low AMH levels, these data should be considered with caution since they mostly involve DHEA supplemented women, and do not discriminate for length and/or form of treatment." @default.
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- W1980929615 date "2009-09-01" @default.
- W1980929615 modified "2023-09-28" @default.
- W1980929615 title "How predictive of basic pregnancy potential are extremly low levels of anti-müllerian hormone (AMH)?" @default.
- W1980929615 doi "https://doi.org/10.1016/j.fertnstert.2009.07.1361" @default.
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