Among individuals with anti-müllerian hormone (AMH) levels of 0.3 ng/mL or lower, researchers sought to calculate the live-birth rate per in vitro fertilization (IVF) cycle and follow cumulative infertility therapy.
Patients who started one or more IVF cycles and had infertility and AMH levels of 0.3 ng/mL or below were the subjects of a retrospective cohort research at a single academic site (2013–2019). Prior chemotherapy, hormonal contraceptive usage within 3 months after the AMH level assessment, and severe male factor infertility were exclusion criteria. Patients were divided into groups according to their Society for Assisted Reproductive Technology (SART) age. The live-birth rate per IVF cycle was the main result. The proportion difference (PD) and 95% CI for live birth outcomes were compared with the 2018 SART National Summary Report for live births per single planned oocyte retrieval.
There were 978 patients altogether. Two cycles (1–3) were started, on average (interquartile range). When compared to the SART live-birth rate per single initiated cycle, the live-birth rate for those with AMH levels of 0.3 ng/mL or lower was significantly lower with the first initiated cycle in each age category (younger than 35 years: 26.2% vs. 55.6%, PD 29.4%, 95% CI 20.9-37.9%; 35-37 years: 15.9% vs. 40.8%, PD 24.9%, 95% CI 19.0-30.9%; 38–40 years: 12.6% vs. 26.8%, PD 14.3%, 95% CI 10.2–18.3%; 4.1–42 years: 4.7% vs. 13.4%, PD 8.7%, 95% CI 5.9-11.6%; older than 42 years: 1.2% vs. 4.1%, PD 2.9%, 95% CI 1.5-4.3%). The cumulative live-birth rate after up to 3 initiated cycles in patients aged 35–37, 38–40, 41–42, and older than 42 years was comparable to the SART live-birth rate after a single initiated cycle, but it remained significantly lower in patients younger than age 35 years (PD 16.8%, 95% CI 7.3-26.2%). Live-birth rates were comparable to SART live-birth rates per single started cycle in all age groups when all treatments (cumulative IVF, ovulation induction, and unaided cycles) were taken into account.
Patients with AMH levels of 0.3 ng/mL or below had a considerably decreased likelihood of having a live delivery during their first started to cycle when compared to national results.
