Use of in-cycle antimüllerian hormone levels to predict cycle outcome


      The goal of this work is to expand the usefulness of antimüllerian hormone (AMH) in predicting in vitro fertilization cycle outcome by demonstrating that AMH concentration obtained in an ongoing treatment cycle predicts both oocyte number and pregnancy.

      Study Design

      Serum samples were obtained from 190 in vitro fertilization patients at onset of follicle-stimulating hormone stimulation. These were analyzed retrospectively during a single cycle in which clinicians were blinded to the results. Our major outcome measures were the number of oocytes obtained and ongoing pregnancy.


      Patients with an initial AMH concentration of >3 ng/mL were found to produce a mean of 19.8 oocytes and had an ongoing pregnancy rate of 60.3%. In contrast, those with AMH values of ≤1 ng/mL yielded a mean of 6.2 oocytes and had an ongoing pregnancy rate of 23.4% (P < .0001 for both).


      Greater AMH serum concentration strongly predicts an increased number of oocytes and ongoing pregnancy (P ≤ .0001).

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Obstetrics & Gynecology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • La Marca A.
        • Stabile G.
        • Artenisio A.C.
        • Volpe A.
        Serum anti-müllerian hormone throughout the human menstrual cycle.
        Hum Reprod. 2006; 21: 3103-3107
        • Streuli I.
        • Fraisse T.
        • Chapron C.
        • Bijaoui G.
        • Bischof P.
        • de Ziegler D.
        Clinical uses of anti-müllerian hormone assays: pitfalls and promises.
        Fertil Steril. 2009; 91: 226-230
        • Hazout A.
        • Bouchard P.
        • Seifer D.B.
        • Aussage P.
        • Junca A.M.
        • Cohen-Bacrie P.
        Serum antimüllerian hormone/müllerian-inhibiting substance appears to be a more discriminatory marker of assisted reproductive technology outcome than follicle-stimulating hormone, inhibin B, or estradiol.
        Fertil Steril. 2004; 82: 1323-1329
        • Broer S.L.
        • Mol B.W.
        • Hendriks D.
        • Broekmans F.J.
        The role of antimüllerian hormone in prediction of outcome after IVF: comparison with the antral follicle count.
        Fertil Steril. 2009; 91: 705-714
        • Elgindy E.A.
        • El-Haieg D.O.
        • El-Sebaey A.
        Anti-müllerian hormone: correlation of early follicular, ovulatory and midluteal levels with ovarian response and cycle outcome in intracytoplasmic sperm injection patients.
        Fertil Steril. 2008; 89: 1670-1676
        • Seifer D.B.
        • MacLaughlin D.T.
        • Christian B.P.
        • Feng B.
        • Shelden R.M.
        Early follicular serum müllerian-inhibiting substance levels are associated with ovarian response during assisted reproductive technology cycles.
        Fertil Steril. 2002; 77: 468-471
        • Nelson S.M.
        • Yates R.W.
        • Fleming R.
        Serum anti-müllerian hormone and FSH: prediction of live birth and extremes of response in stimulated cycles–implications for individualization of therapy.
        Hum Reprod. 2007; 22: 2414-2421
        • Riggs R.M.
        • Duran E.H.
        • Baker M.W.
        • et al.
        Assessment of ovarian reserve with anti-müllerian hormone: a comparison of the predictive value of anti-müllerian hormone, follicle-stimulating hormone, inhibin B, and age.
        Am J Obstet Gynecol. 2008; 199: 202.e1-202.e8
        • Silberstein T.
        • MacLaughlin D.T.
        • Shai I.
        • et al.
        Müllerian inhibiting substance levels at the time of HCG administration in IVF cycles predict both ovarian reserve and embryo morphology.
        Hum Reprod. 2006; 21: 159-163
        • Barad D.H.
        • Weghofer A.
        • Gleicher N.
        Comparing anti-müllerian hormone (AMH) and follicle-stimulating hormone (FSH) as predictors of ovarian function.
        Fertil Steril. 2009; 91: 1553-1555
        • Kwee J.
        • Schats R.
        • McDonnell J.
        • Themmen A.
        • de Jong F.
        • Lambalk C.
        Evaluation of anti-müllerian hormone as a test for the prediction of ovarian reserve.
        Fertil Steril. 2008; 90: 737-743
        • Eldar-Geva T.
        • Ben-Chetrit A.
        • Spitz I.M.
        • et al.
        Dynamic assays of inhibin B, anti-müllerian hormone and estradiol following FSH stimulation and ovarian ultrasonography as predictors of IVF outcome.
        Hum Reprod. 2005; 20: 3178-3183
        • Ebner T.
        • Sommergruber M.
        • Moser M.
        • Shebl O.
        • Schreier-Lechner E.
        • Tews G.
        Basal level of anti-müllerian hormone is associated with oocyte quality in stimulated cycles.
        Hum Reprod. 2006; 21: 2022-2026
        • Nelson S.M.
        • Yates R.W.
        • Lyall H.
        • et al.
        Anti-müllerian hormone-based approach to controlled ovarian stimulation for assisted conception.
        Hum Reprod. 2009; 24: 867-875
        • La Marca A.
        • Broekmans F.J.
        • Volpe A.
        • Fauser B.C.
        • Macklon N.S.
        Anti-müllerian hormone (AMH): what do we still need to know?.
        Hum Reprod. 2009; 24: 2264-2275
        • Merhi Z.O.
        • Minkoff H.
        • Feldman J.
        • Macura J.
        • Rodriguez C.
        • Seifer D.B.
        Relationship of bariatric surgery to müllerian-inhibiting substance levels.
        Fertil Steril. 2008; 90: 221-224
        • Thomson R.L.
        • Buckley J.D.
        • Moran L.J.
        • et al.
        The effect of weight loss on anti-müllerian hormone levels in overweight and obese women with polycystic ovary syndrome and reproductive impairment.
        Hum Reprod. 2009; 24: 1976-1981
        • Fanchin R.
        • Schonauer L.M.
        • Righini C.
        • Frydman N.
        • Frydman R.
        • Taieb J.
        Serum anti-müllerian hormone dynamics during controlled ovarian hyperstimulation.
        Hum Reprod. 2003; 18: 328-332
        • La Marca A.
        • Malmusi S.
        • Giulini S.
        • et al.
        Anti-müllerian hormone plasma levels in spontaneous menstrual cycle and during treatment with FSH to induce ovulation.
        Hum Reprod. 2004; 19: 2738-2741
        • Winkler N.
        • Bukulmez O.
        • Hardy D.B.
        • Carr B.R.
        Gonadotropin releasing hormone antagonists suppress aromatase and anti-müllerian hormone expression in human granulosa cells.
        Fertil Steril. 2010; 94: 1832-1839
        • Streuli I.
        • Fraisse T.
        • Pillet C.
        • Ibecheole V.
        • Bischof P.
        • de Ziegler D.
        Serum antimüllerian hormone levels remain stable throughout the menstrual cycle and after oral or vaginal administration of synthetic sex steroids.
        Fertil Steril. 2008; 90: 395-400
        • Wu C.H.
        • Chen Y.C.
        • Wu H.H.
        • Yang J.G.
        • Chang Y.J.
        • Tsai H.D.
        Serum anti-müllerian hormone predicts ovarian response and cycle outcome in IVF patients.
        J Assist Reprod Genet. 2009; 26: 383-389