Assessment of the relationship of basal serum anti mullerian hormone levels and maternal age with pregnancy out come in patients undergoing icsi

Abstract

The effects of maternal age on pregnancy outcomes are well known, particularly the association of advanced maternal age with poor ART results. Decreased ovarian reserve and decreased endometrial receptivity resulting from increased age are likely reasons for this observed reduction in fertility. AMH plays a role in regulating ovarian activity. Additionally, it inhibits initiation of the development of primordial follicles and the selection of a high number of follicles by decreasing the follicles' sensitivity to follicle stimulating hormone (FSH). The aim of the study is to assess the relationship of basal serum antimullerian hormone level and maternal age with oocyte quality and embryo quality and pregnancy outcomes in patient undergoing ICSI. The current observational prospective study included 100 infertile women who underwent ICSI at The High Institute of Infertility Diagnosis and Assisted Reproductive Technology/AL-Nahrian University, for the period from September 2018 to June 2019. All patients were treated with a GnRH antagonist protocol. Hormonal assay was performed using ELISA technique (BioTek, USA and CAT# AM448T, CalbiotechInc, CA, USA). At the end of the ICSI cycles 29 women have succeeded to get positive clinical pregnancy, while 71 women unfortunately have failed to get pregnant; thus the clinical pregnancy rate was 29 %. When subfertile women were classified into 4 subgroups, positive pregnancy outcome was significantly highest in women with age ≤ 33 and AMH > 1.63 (73.1 %), followed by women with age ≤ 33 and AMH ≤ 1.63 (21.7 %), then women with age > 33 and AMH ≤ 1.63 (9.1 %) and lastly by women with age > 33 and AMH > 1.63 (8.7 %). Age less than 33 and serum anti-mullerian hormone (AMH) levelof > 1.63 ng/ml are the best predictor of pregnancy in subfertile women undergoing intracytoplasmic sperm injection (ICSI).