Serum Level of Anti-Mullerian Hormone in Early Follicular Phase as a Predictor of Ovarian Reserve and Pregnancy Outcome in Assisted Reproductive Technology Cycles

Anti-Mullerian hormone is produced by the granulosa cells of preantral and small antral follicles. The objective of this study was to investigate whether anti-Mullerian hormone and antral follicle count can be useful in predicting the ovarian reserve and pregnancy outcome in assisted reproductive technology cycles. This prospective study included a total of 60 patients attending an assisted reproductive technology program. Patients with an oocyte count of ≥4 were considered good responders (group A); those with <4 oocytes were considered as poor responders (group B). On day three of the menstrual cycle, blood sample was taken from each woman for the measurement of serum levels of FSH, LH, E2, and anti-Mullerian hormone. Thereafter, ovarian ultrasound scanning was performed to evaluate the number and size of antral follicles. Parameters such as serum FSH, LH, and E2 levels were not statistically different between the two groups. Meanwhile, the difference between serum anti-Mullerian hormone levels, AFC, HCG day follicle counts, and retrieved oocyte counts were statistically significant in the two groups. The mean±SD serum anti-Mullerian hormone level was 34.22±13.95 and 12.53±9.4 pM/mL in groups A and B, respectively (P=0.002). The number of chemical pregnancies was seven versus three in groups A and B, respectively (P=0.014), whereas the number of clinical pregnancies was six versus two in groups A and B, respectively (P =0.52). It appears that there is an association between the serum level of anti-Mullerian hormone in early follicular phase and ovarian reserve. Furthermore, a higher serum level of anti-Mullerian hormone on day three is associated with chemical pregnancy success