Influence of Anti-Mullerian Hormone on ART Outcomes in Infertility Patients of Different Ages

Abstract

Changes in life patterns in most developed countries have resulted in marriage at a later age. The mean age of couples has increased gradually, which may expose them to an age-related fertility disorder. Such social and clinical cases are considered a serious problem that leads to population decline. Aging accompanies diminished ovarian reserves and further understanding of reproductive physiology at middle age is critical for mobilizing developmentally competent oocytes during infertility treatment in aging women. Thus, establishing new parameters to precisely predict fecundity of a patient contributes to developing an efficient applied reproductive technology (ART) program for couples that marry late. Aging induces a gradual decrease in the level of endogenous antiMullerian hormone (AMH), which directly influences the number of primordial follicles [1-3] and the sensitivity of the ovarian follicles to the follicle stimulating hormone (FSH)-dependent follicular wave [4] and folliculogenesis [5, 6]. Due to its relationship with endogenous FSH levels, AMH has been used as a parameter to evaluate the status of the controlled ovarian hyperstimulation cycle [7-13]. Based on previous reports, we evaluated whether measuring blood AMH levels would be useful to predict ART outcomes in middle-aged, infertile patients. Two major factors, the AMH level and patient age, were used to categorize the patients, and various patient profiles and ART outcomes including