Evaluation of assisted reproductive technology treatment outcomes based on stimulation dosages and anti-Mullerian hormone levels

Abstract

Background: Serum levels of anti-Müllerian hormone (AMH) have a significant association with ovarian response in the event of assisted reproductive technology (ART) treatment cycles. The present study was performed to evaluate the ovarian stimulation protocols selection with respect to serum AMH levels in patients and its impact on ART outcome. Methods: Based on the serum AMH, 191 women were classified as low, normal and high responders. Follicle Stimulating Hormone (FSH) and Human Menopausal Gonadotropin (HMG) dosages in controlled ovarian stimulation were determined. Retrieval, maturation, fertilization and utilization rates were measured. Subgroup analysis was done using one-way ANOVA followed by post hoc analysis. The relationship between AMH levels and fertilization was determined using Pearson’s correlation analysis. A p-value <0.05 was considered as statistically significant. Results: According to AMH levels, the majority of the patients were normal responders (52.4%) followed by high responders (29.8%) and low responders (17.8%). The average FSH, HMG per day and number of days HMG required was found to be significant among the different responders. Further, retrieval rate and blastulation rate was found to be significant among the different responders. A positive correlation was found between AMH and the number of oocytes retrieved and number of oocytes successfully fertilized, which was found to be significant. In addition, there was a significant inverse relationship between AMH levels and age. Conclusions: The study outcomes revealed that the rates of retrieval, maturation, fertilization, embryo utilization and blastulation were higher among the high responders compared with the low responders. Thus, proper increase in dosages of ovarian stimulation protocol is required among the low responders to achieve quality embryos.