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DATA

Predicting Live Birth in Women Undergoing IVF by Analyzing Hormone Follicles

S. Wang, Y. Zhang, V. Mensah, W.J. Huber, Y.-T. Huang, R. Alvero

August 2, 2017
Emma Holt

Investigating the roles of AMH & FSH

Why this matters

Researchers, S. Wang, Y. Zhang, V. Mensah, W.J. Huber, Y.-T. Huang, and R. Alvero from the Department of Obstetrics & Gynecology, Warren Alpert Medical School of Brown University, and Women & Infants Hospital of Rhode Island set out to investigate the roles of Anti-müllerian hormone (AMH) (AMH) and follicle stimulating hormone (FSH) in predicting live births. Women trying to conceive may have an AMH test ordered to estimate the remaining time left to conceive, and FSH may help control menstrual cycles and the production of eggs by the ovaries. FSH may be measured in both men and women to determine why a couple cannot get pregnant.

For 20 years, AMH and FSH have been used as a prognostic factor in assessing ovarian reserve in infertility patients. The goal of this study is to clarify the values of the two in predicting live birth independently and relative to each other.

In this condensed article, you’ll learn:

  • How the cycles were evaluated and when
  • Who and what exactly the researchers studied
  • The results and what they mean for future predictions of live births moving forward 

‍Methods of Research

Evaluation of the cycles  

From 2000 to 2016, the dataset the researchers attained consisted of 144,044 fresh cycles from 60 centers in the United States. The team evaluated 13,964 cycles with AMH, FHS, age, body mass index (BMI), and birth outcomes. 

Variables such as incomplete cycles, non-autologous donor cycles, unknown or missing cycle information, or contained outlier variables were excluded from this research. It’s also important to note that many cycles before 2009 were excluded because of missing AMH values since AMH has only been adopted in clinical use in the past few years. The final dataset contained 13,064 autologous (obtained from the same individual) IVF cycles with known AMH, FSH, and confirmed determination of live birth. 

Results of the study

Categorization of the groups and their outcomes

Patients of this study were categorized into four groups: Group I - good prognosis group, Group II - poor prognosis group, Group III - reassuring AMH group, and Group IV - reassuring FSH group. 

The extensive analysis revealed a “nonlinear relationship” of AMH and FSH with live birth rate among all ages. The good prognosis group had the highest live birth rate while the poor prognosis group had the lowest live birth rate, which should come as no surprise. In the discordant groups, the live birth rate of the reassuring AMH group was significantly higher than the reassuring group.

Conclusion and summary

What happens now?

Among all age groups, AMH appears to be exclusively better than FSH, even though both are used to assess the ovarian reserve in women being evaluated for infertility. Researchers can reassure that AMH is a better clinical predictor of cycle success than FSH. This is particularly important for patients with discordant AMH and FSH. Moving forward, the newer clinical use of the Anti-müllerian hormone may be used more than the follicle stimulating hormone to predict live births and assess ovarian reserve in infertile patients.

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