The role of follicular fluid anti-mullerian hormone in success rate of intracytoplasmic sperm injection

Abstract

BACKGROUND: The role of anti-Mullerian hormone (AMH) in the ovary is to participate in the regulation of ovarian function, especially in follicle development and selection. It inhibits the initiation of human primordial follicle growth and prevents multiple selection of a dominant follicle by reducing the sensitivity of follicles to follicle stimulating hormone. MATERIALS AND METHODS: In this prospective clinical trial, outcomes were followed in 60 women undergoing cycles of in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) within El-Minia University Hospital. AMH concentration was estimated in pooled follicle fluid (FF) on day of oocyte pickup. Cycles were sorted into low and high groups according to median (50th centile) values of measurement. The fertilization rate (FR), implantation rate, blastocyst development, embryo quality, chemical pregnancy, clinical pregnancy, and ongoing pregnancy after ICSI were counted as the main outcomes. RESULTS: Low FF AMH group shows significantly higher percentage of top-quality oocytes (67.1 ± 24.3 vs. 49.6 ± 30.3 %, p = 0.014), FR (83.9 ± 20.9 vs. 72.4 ± 21.4%, p = 0.021), clinical pregnancy (57.57 vs. 16.67%, p > 0.0001), and embryo implantation rates (57.7 vs. 16.7%, p = 0.001) compared to high FF AMH group. FF AMH shares an inverse correlation with FF E2 (Pearson r = −0.409, p < 0.001) and clinical pregnancy (Pearson r = −0.618, p < 0.001). Threshold value of FF AMH for pregnancy is >1.75 ng/mg protein. CONCLUSION: FF AMH is a plausible specific indicator of functional viability and quality of oocyte in IVF cycles.