Skip to main content
SpringerLink
Log in

The significance of serum anti-Müllerian hormone (AMH) levels in patients over age 40 in first IVF treatment

  • Gonadal Physiology and Disease
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Purpose

Although studies of serum anti-Müllerian hormone (AMH) in predicting ovarian reserve are numerous, many studies utilized patients under age 40. However, the assessment of ovarian reserve is especially critical in older infertile women. This study evaluates the significance of AMH level in patients over age 40 at the time of their first in vitro fertilization (IVF) treatment.

Methods

Forty-nine women over age 40 were studied. Although serum samples were taken prior to their IVF treatments, the data of serum AMH of patients were not taken into consideration to determine the therapy strategy, including follicle induction in which clomiphene citrate and human menopausal gonadotropin were used.

Result(s)

Twelve out of 49 patients achieved a clinical pregnancy (24.4 %). There was a positive correlation between serum AMH levels and the number of oocytes retrieved (P < 0.0001). The ROC curve analysis for prediction of poor ovarian response, ≤3 retrieved oocytes, showed that the optimum cut-off level was < 1.0 ng/mL for AMH. The lower AMH group (AMH < 1.0 ng/ml) showed less chance of undergoing embryo transfer than the higher AMH group (AMH ≥1.0 ng/ml). There was no difference in pregnancy rate between the two groups. Five out of 12 pregnant women exhibited AMH levels of less than 0.4 ng/ml.

Conclusion(s)

Assessment of serum AMH concentration in older patients is useful for the prediction of oocytes numbers which may be obtained in IVF. A cut-off level of 1.0 ng/ml AMH can be used to predict poor ovarian response. This cut-off level of AMH of 1.0 ng/ml might be useful to predict whether patients could have an embryo transfer, but had no power to predict achieving pregnancy. On the other hand, our data also showed that patients over age 40 with extreme low levels of AMH still had a chance of pregnancy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Broekmans FJ, Kwee J, Hendriks DJ, Mol BW, Lambalk CB. A systematic review of tests predicting ovarian reserve and IVF outcome. Hum Reprod Updat. 2006;12(6):685–718.

    Article  CAS  Google Scholar 

  2. Broer SL, Mol BWJ, Hendriks D, Broekmans FJM. Role of antimullerian hormone in prediction of outcome after IVF: comparison with the antral follicle count. Fertil Steril. 2009;91(3):705–14.

    Article  PubMed  CAS  Google Scholar 

  3. Ferraretti AP et al. ESHRE consensus on the definition of ‘poor response’ to ovarian stimulation for in vitro fertilization: the Bologna criteria. Human Reprod (Oxford, England). 2011;26(7):1616–24.

    Article  CAS  Google Scholar 

  4. Fujimoto A et al. Predictive factors of successful pregnancy after assisted reproductive technology in women aged 40 years and older. Reprod Med Biol. 2009;8(4):145–9.

    Article  Google Scholar 

  5. Khader A et al. External validation of anti-Müllerian hormone based prediction of live birth in assisted conception. J Ovarian Res. 2013;6(1):3.

    Article  PubMed  Google Scholar 

  6. Leridon H. Demographic effects of the introduction of steroid contraception in developed countries. Hum Reprod Updat. 2006;12(5):603–16.

    Article  Google Scholar 

  7. Lie Fong S et al. Anti-Müllerian hormone: a marker for oocyte quantity, oocyte quality and embryo quality? Reprod Biomed Online. 2008;16(5):664–70.

    Article  PubMed  CAS  Google Scholar 

  8. La Marca A et al. Anti-Mullerian hormone (AMH) as a predictive marker in assisted reproductive technology (ART). Hum Reprod Updat. 2010;16(2):113–30.

    Article  Google Scholar 

  9. La Marca A, Stabile G, Carducci Artenisio A, Volpe A. Serum anti-Mullerian hormone throughout the human menstrual cycle. Human Reprod (Oxford, England). 2006;21(12):3103–7.

    Article  Google Scholar 

  10. Van Rooij IAJ et al. Serum anti-Müllerian hormone levels: a novel measure of ovarian reserve. Human Reprod (Oxford, England). 2002;17(12):3065–71.

    Article  Google Scholar 

  11. Spandorfer SD et al. An analysis of the effect of age on implantation rates. J Assist Reprod Genet. 2000;17(6):303–6.

    Article  PubMed  CAS  Google Scholar 

  12. Spira A. The decline of fecundity with age. Maturitas Suppl. 1988;1:15–22.

    Article  Google Scholar 

  13. Weenen C et al. Anti-Müllerian hormone expression pattern in the human ovary: potential implications for initial and cyclic follicle recruitment. Mol Hum Reprod. 2004;10(2):77–83.

    Article  PubMed  CAS  Google Scholar 

  14. Weghofer A, Dietrich W, Barad DH, Gleicher N. Live birth chances in women with extremely low-serum anti-Mullerian hormone levels. Human Reprod (Oxford, England). 2011;26(7):1905–9.

    Article  CAS  Google Scholar 

Download references

Acknowledgments

We thank Ms. Mitsuyo Kakimoto for her editorial assistance. We also thank Dr. Heather M. Martinez for her helpful discussion and critical reading of the manuscript.

Grants

This work was supported by Health and Labor Sciences Research Grants from the Ministry of Health, Labor and Welfare of Japan, Grant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Tokyo, Tokyo, 113-8655, Japan

    Osamu Yoshino, Sayaka Ogura-Nose, Miyuki Harada, Yutaka Osuga & Shiro Kozuma

  2. Department of Obstetrics and Gynecology, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan

    Osamu Yoshino

  3. Department of Obstetrics and Gynecology, Mizonokuchi Hospital, Teikyo University, Kawasaki, 213-8507, Japan

    Yoko Tokura, Osamu Yoshino & Osamu Nishii

  4. Denentoshi Ladies Clinic Reproductive Center, Kanagawa, 227-0062, Japan

    Hiroshi Motoyama, Yasushi Shimizu, Motohiro Ohara, Takeshi Yorimitsu & Toshihiro Kawamura

Authors
  1. Yoko Tokura
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Osamu Yoshino
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sayaka Ogura-Nose
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hiroshi Motoyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Miyuki Harada
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yutaka Osuga
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yasushi Shimizu
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Motohiro Ohara
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Takeshi Yorimitsu
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Osamu Nishii
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Shiro Kozuma
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Toshihiro Kawamura
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Osamu Yoshino.

Additional information

Capsule

In IVF patients over age 40, a cut-off level of 1.0 ng/ml AMH can be used to predict poor ovarian response. But patients with extreme low levels of AMH (<0.4 ng/ml) still had a chance of pregnancy.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tokura, Y., Yoshino, O., Ogura-Nose, S. et al. The significance of serum anti-Müllerian hormone (AMH) levels in patients over age 40 in first IVF treatment. J Assist Reprod Genet 30, 821–825 (2013). https://doi.org/10.1007/s10815-013-9991-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10815-013-9991-3

Keywords

Search

Navigation