الفهرس 
POLYCYSTIC OVARY SYNDROME (PCOS)Only 14 pages are availabe for public view
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Abstract
Background: Anti-Mullerian hormone (AMH) is a dimeric glycoprotein member of the TGF-β family. In women, AMH is derived primarily from pre-antral and early antral follicles and has been shown in recent years to accurately reflect the follicular pool.
Objective: To investigate the relation between serum antimullerian hormone levels and IVF outcomes in infertile women with PCOS.
Patients and Methods: This retrospective study was conducted at assisted reproductive technology unit (ARTU) of Ain Shams University Maternity Hospital (ASUMT) between February 2021 and February 2022 to investigate the relation between serum anti mullerian hormone levels and IVF outcomes in infertile women with PCOS. A total of 200 infertile an-ovulatory PCOS women who underwent IVF/ICSI were enrolled.
Results: As regard AMH level and its correlation with IVF, maternal and fetal complications, current study stated that there were no significant statistical correlations between AMH level and abortion, preterm labor, pregnancy induced hypertension, gestational DM, ante partum hemorrhage, multiple pregnancy and NICU admission; p= 0.976, 0.880, 0.500, 0.675, 0.903, 0.559 and 0.864 respectively. On the other hand, AMH was significantly higher in in cases that had ovarian hyper stimulation syndrome, p= 0.003. In respect of diagnostic performance of AMH level in predicting different outcomes, AMH level at ≥ 2.4 ng/mL cut point statistically had significant moderate diagnostic performance in predicting biochemical pregnancy, clinical pregnancy and live birth. AMH level at (≥ 2.5 and ≤ 8.3) ng/dL had high sensitivity (89%), PPV (73.9%) and NPV (57.1%) but low specificity (31.7%) in predicting biochemical pregnancy. Regarding predicting clinical pregnancy, AMH level at (≥ 2.5 and ≤ 8.3) ng/dL had high sensitivity (91%), NPV (68.6%) and PPV (67.3%) but low specificity (30.8%). In predicting live birth, AMH level at(≥ 3.0 and ≤ 8.3) ng/dL had high sensitivity (88.4%), NPV (69.8%) and PPV (63.1%) but low specificity (34.1%). Finally as shown in this study, the higher AMH level above 8.3 ng/dL, the lower the ovulation and pregnancy outcomes. On the other hand, the higher AMH level above 5 ng/dL, the higher the ovarian hyper stimulation syndrome and according to our knowledge, there were no previous studies assessed these outcomes.
Conclusion: AMH is negative correlated with maternal age. AMH has no effect on stimulation duration and total dose of induction of ovulation. AMH level is statistically significantly correlated with biochemical pregnancy, clinical pregnancy and live birth rates. AMH is significantly higher in cases that had ovarian hyperstimulation syndrome. AMH level at ≥ 2.4 ng/mL cut point statistically has significant moderate diagnostic performance in predicting biochemical pregnancy, clinical pregnancy and live birth. On the other hand, AMH statistically has significant low diagnostic performance in predicting ovulation.