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Anti Mullerian Hormone: Can We Ever Say – No Treatment!


Predictive ovarian reserve is one of the most important diagnostic tools prior to IVF. Antral follicle count (AFC) and anti mullerian hormone (AMH) are the most significant predictors of response during an IVF cycle.

There is a correlation between declining AMH reserves and the chances of having a live birth. Whether or not a dramatic decline in AMH reduces the chances of pregnancy was reviewed by our study which was published in Gynaecol Endocrinol 29, 662-665, 2013.

In the study we demonstrated that women with very low AMH under 3pmol / lt had poorer outcomes with IVF treatment with a high cancellation rate. Clinical pregnancy rates were very low at 4.4% but while in younger women under thirty five, pregnancy rates although continued to be low at about 8.3%. Thus, there is some evidence that a very low AMH does significantly decline the chances of pregnancy when compared to women with a higher AMH at the same age.

Although the chances of pregnancy are very poor, it would be very difficult to say whether, in IVF treatment, the use of very low AMH can indicate that the treatment is futile and should not be offered. Although we have shown that the pregnancy rates are extremely low, we have also demonstrated that at the very low AMH levels, pregnancies do occur albeit at a lower success. Thus at very low AMH , there seems to be a quantity decline of eggs as well as a decline in the quality of eggs.

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