Anti-Mullerian Hormone as a Predictive Factor in Assisted Reproductive Technique of Polycystic Ovary Syndrome Patients

  • Ashraf Aleyasin Mail Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Marzie Aghahoseini Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Sara Mokhtar Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Parvin Fallahi Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Anti-Mullerian hormone, Polycystic ovary syndrome, Assisted Reproductive technique


This study aimed to assess the relationship between the serum levels of anti-mullerian hormone (AMH) and other hormonal markers and results of assisted reproductive techniques (ART) in polycystic ovary syndrome (PCOS) patients. This cohort study was conducted on 60 PCOS patients who were candidates for assisted reproductive techniques. In all patients the serum levels of AMH, follicle stimulating hormone (FSH) and luteinizing hormone (LH), estradiol (E2), free testosterone (fT), testosterone (T) and inhibin B were measured in the 3rd day of menstrual cycle. The relationship between serum level of measured hormonal markers with retrieved oocytes, mature oocytes, the number of transferred fetus and pregnancy rate were assessed. The cut-off value for the serum level of AMH and retrieved oocytes were determined. There was a significant direct correlation between the serum mullerian inhibiting substance (MIS) level with number of total picked up oocytes (r=0.412), mature oocytes (r=0.472) and embryo transfer (r=0.291). There was a linear and significant correlation between inhibin B and fertilization (r=0.283) Cut-off point for AMH level according to presence or absence of pregnancy was 4.8 ng/ml and it was not statistically significant (P=0.655). Area under curve (AUC) was 0.543. Cut-off point for MIS according to picked up oocytes was 2.7 ng/ml with area under the curve (ROC curve) of 0.724 (CI= 0.591-0.831) (P=0.002). Patients with PCOS who had AMH more than 2.7 ng/ml, the number of retrieved oocytes (6 or more) was higher than MIS/AMH <2.7 ng/ml (P=0.002). As a marker of ovarian responsiveness to controlled ovarian hyperstimulation (COH) and despite a small sample size of our study, it is revealed that pretreatment MIS/AMH is highly associated with the number of mature oocytes retrieved during COH in PCOS women.


van Rooij IA, Tonkelaar I, Broekmans FJ, Looman CW, Scheffer GJ, de Jong FH, Themmen AP, te Velde ER. Anti-müllerian hormone is a promising predictor for the occurrence of the menopausal transition. Menopause2004;11(6 Pt 1):601-6.

La Marca A, Broekmans FJ, Volpe A, Fauser BC, Macklon NS; ESHRE Special Interest Group for Reproductive Endocrinology: AMH Round Table. Anti- Mullerian hormone (AMH): what do we still need to know? Hum Reprod 2009;24(9):2264-75.

Broer SL, Mol BW, Hendriks D, Broekmans FJ. The role of antimullerian hormone in prediction of outcome after IVF: comparison with the antral follicle count. Fertil Steril2009;91(3):705-14.

Nardo LG, Gelbaya TA, Wilkinson H, Roberts SA, Yates A, Pemberton P, Laing I. Circulating basal anti-Müllerian hormone levels as predictor of ovarian response in women undergoing ovarian stimulation for in vitro fertilization. Fertil Steril 2009;92(5):1586-93. Epub 2008 Oct 18.

Desforges-Bullet V, Gallo C, Lefebvre C, Pigny P, Dewailly D, Catteau-Jonard S. Increased anti-Müllerian hormone and decreased FSH levels in follicular fluid obtained in women with polycystic ovaries at the time of follicle puncture for in vitro fertilization. Fertil Steril 2010;94(1):198-204.

Fleming R, Deshpande N, Traynor I, Yates RW. Dynamics of FSH-induced follicular growth in subfertile women:relationship with age, insulin resistance, oocyte yield and anti-Mullerian hormone. Hum Reprod 2006;21(6):1436-41.

La Marca A, Orvieto R, Giulini S, Jasonni VM, Volpe A, De Leo V. Mullerian-inhibiting substance in women withpolycystic ovary syndrome: relationship with hormonaland metabolic characteristics. Fertil Steril 2004;82(4):970-2.

Wang JG, Nakhuda GS, Guarnaccia MM, Sauer MV, Lobo RA. Müllerian inhibiting substance and disruptedfolliculogenesis in polycystic ovary syndrome. Am J Obstet Gynecol 2007;196(1):77.e1-5.

Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnosticcriteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod 2004;19(1):41-7.

Chu MC, Carmina E, Wang J, Lobo RA. Müllerianinhibiting substance reflects ovarian findings in women with polycystic ovary syndrome better than does inhibin B. Fertil Steril 2005;84(6):1685-8.

van Rooij IA, Broekmans FJ, te Velde ER, Fauser BC, Bancsi LF, de Jong FH, Themmen AP. Serum anti- Müllerian hormone levels: a novel measure of ovarian reserve. Hum Reprod 2002;17(12):3065-71.

Muttukrishna S, Suharjono H, McGarrigle H, Sathanandan M. Inhibin B and anti-Mullerian hormone: markers of ovarian response in IVF/ICSI patients? BJOG 2004;111(11):1248-53.

Fiçicioglu C, Kutlu T, Baglam E, Bakacak Z. Earlyfollicular antimüllerian hormone as an indicator of ovarian reserve. Fertil Steril 2006;85(3):592-6.

Hazout A, Bouchard P, Seifer DB, Aussage P, Junca AM, Cohen-Bacrie P. Serum antimüllerian hormone/müllerianinhibiting substance appears to be a more discriminatory marker of assisted reproductive technology outcome than follicle-stimulating hormone, inhibin B, or estradiol. Fertil Steril 2004;82(5):1323-9.

Barriere P, Freour T, Mirallie S, Jean M, Bach-Ngohou K, Masson D. P-413: Anti-mullerian hormone (AMH): Proposition of a cut-off in assisted reproductive therapy (ART) for a promising new marker (measured withBeckman Coulter ELISA). Fertil Steril 2006;86(Supplement 3):S289. Peñarrubia J, Fábregues F, Manau D, Creus M, Casals G, 16. Casamitjana R, Carmona F, Vanrell JA, Balasch J. Basal and stimulation day 5 anti-Mullerian hormone serum concentrations as predictors of ovarian response and pregnancy in assisted reproductive technology cycles stimulated with gonadotropin-releasing hormone agonist: gonadotropin treatment. Hum Reprod 2005;20(4):915-22.

How to Cite
Aleyasin A, Aghahoseini M, Mokhtar S, Fallahi P. Anti-Mullerian Hormone as a Predictive Factor in Assisted Reproductive Technique of Polycystic Ovary Syndrome Patients. Acta Med Iran. 49(11):715-720.