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Role of Baseline Antral Follicle Count and Anti-Mullerian Hormone in Prediction of Cumulative Live Birth in the First In Vitro Fertilisation Cycle: A Retrospective Cohort Analysis

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  • Hang Wun Raymond Li
  • Vivian Chi Yan Lee
  • Estella Yee Lan Lau
  • William Shu Biu Yeung
  • Pak Chung Ho
  • Ernest Hung Yu Ng

Abstract

Objective: This retrospective study determined for the first time the role of baseline antral follicle count (AFC) and serum anti-Mullerian hormone (AMH) level in the first in-vitro fertilisation (IVF) cycle in predicting cumulative live birth from one stimulation cycle. Methods: We studied 1,156 women (median age 35 years) undergoing the first IVF cycle. Baseline AFC and AMH level on the day before ovarian stimulation were analysed. The main outcome measure was cumulative live birth in the fresh plus all the frozen embryo transfers after the same stimulation cycle. Results: Serum AMH was significantly correlated with AFC. Both AMH and AFC showed significant correlation with age and ovarian response in the stimulated cycle and total number of transferrable embryos. Baseline AFC and serum AMH were significantly higher in subjects attaining a live birth than those who did not in the fresh stimulated cycle, as well as those attaining cumulative live birth. There was a significant trend of higher cumulative live birth rate in women with higher AMH or AFC. However, logistic regression revealed that both AMH and AFC were not significant predictors of cumulative live birth after adjusting for age and number of embryos available for transfer. Considering only one single predictor, the areas under the ROC curves for AMH (0.646, 95% CI 0.616–0.675) and age (0.648, 95% CI 0.618–0.677) were slightly higher than that for AFC (0.617, 95% CI 0.587–0.647) in predicting cumulative live birth. However, a model combining AMH (with or without AFC) and age of the women only classified an addition of less than 2% of subjects correctly compared to the model with age alone. Conclusion: Baseline AFC and serum AMH have only modest predictive performance on the occurrence of cumulative live birth, and may not give additional value on top of the women's age.

Suggested Citation

  • Hang Wun Raymond Li & Vivian Chi Yan Lee & Estella Yee Lan Lau & William Shu Biu Yeung & Pak Chung Ho & Ernest Hung Yu Ng, 2013. "Role of Baseline Antral Follicle Count and Anti-Mullerian Hormone in Prediction of Cumulative Live Birth in the First In Vitro Fertilisation Cycle: A Retrospective Cohort Analysis," PLOS ONE, Public Library of Science, vol. 8(4), pages 1-7, April.
    • Handle: RePEc:plo:pone00:0061095
    DOI: 10.1371/journal.pone.0061095
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    Cited by:

    1. Swati Verma & Umesh Nandini Jindal & Sonia Gupta & Sanjeev Maheshwari & Bharti Joshi, 2018. "Outcome of In Vitro Fertilization in Women with Discordant Values of Anti Mullerian Hormone and Antral Follicle Count," Global Journal of Reproductive Medicine, Juniper Publishers Inc., vol. 4(5), pages 82-87, May.
    2. Zhiqin Bu & Feifei Zhao & Keyan Wang & Yihong Guo & Yingchun Su & Jun Zhai & Yingpu Sun, 2014. "Serum Progesterone Elevation Adversely Affects Cumulative Live Birth Rate in Different Ovarian Responders during In Vitro Fertilization and Embryo Transfer: A Large Retrospective Study," PLOS ONE, Public Library of Science, vol. 9(6), pages 1-7, June.

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