AMH Highly Correlates with Cumulative Live Birth Rate in Women with Diminished Ovarian Reserve Independent of Age.

CONTEXT Antimullerian hormone (AMH) level is strongly associated with ovarian response in reproductive technology (ART) cycles but is a poor predictor of live birth. It is unknown whether AMH is associated with cumulative live birth rates (CLBR) in women with diminished ovarian reserve (DOR). OBJECTIVE To examine the association between serum AMH and CLBR among women with DOR undergoing ART. DESIGN Retrospective analysis of Society for Assisted Reproductive Technology Clinic Outcome Reporting System database 2014-16. SETTING Not applicable. PATIENTS A total of 34,540 index retrieval cycles of women with AMH<1 ng/ml. INTERVENTIONS None. MAIN OUTCOME MEASURES Cumulative live birth. RESULTS A total of 34,540 (25.9%) cycles with AMH<1 ng/ml out of 133,442 autologous index retrieval cycles were analyzed. Cycles with preimplantation genetic testing or egg/embryo banking were excluded. Data was stratified according to AMH and age and regression analysis of AMH and CLBR was performed for each age strata. Multiple logistic regression demonstrated that AMH is an independent predictor of CLBR (Odds ratio 1.39, 95%CI 1.18-1.64). Serum AMH was strongly associated with number of oocytes retrieved, embryos cryopreserved, mean number of cumulative embryos transferred, and percentage of cycles that had an embryo transfer,. Linear regression analysis demonstrated that AMH highly correlated with CLBR in each age strata. CONCLUSIONS Serum AMH is highly correlated with CLBR in women with DOR independent of age. The addition of AMH to current age-based prognostication counseling particularly in women with DOR would provide more informative and personalized CLBR prediction prior to ART.