Κατεύθυνση Παθολογία της ΚύησηςLibrary of the School of Health Sciences
Καλανταρίδου Σοφία, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Παπαντωνίου Νικόλαος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Συριστατίδης Χαράλαμπος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Αξιολόγηση της Αντιμυλλέριου ορμόνης για την καλή έκβαση της εξωσωματικής γονιμοποίησης με γέννηση ζώντος νεογνού - μια περιγραφική ανασκόπηση
Evaluation of Anti-mulerian hormone for good IVF outcome with live birth - a descriptive review
INTRODUCTION: To evaluate the good outcome of IVF with live birth, special biomarkers are used either as independent prognostic factors or in combination with ultrasound findings of the patient in the context of prognostic models.
METHOD: Bibliographic review of ovarian stimulation protocols, their complications and ovarian reserve factors with emphasis on AMH and its clinical applications. Electronic databases such as PubMed, ESHRE, RCOG and Wikipedia were studied using keywords and bibliographic references of Greek and international publications such as OBSTETRICS AND GYNECOLOGY, Infertility in Practice, The BOSTON IVF Handbook of Infertility, Williams GYNECOLOGY.
RESULTS: Ovarian reserve factors such as AMH, AFC, patient age, FSH and estradiol are prognostic markers for good IVF outcome with live birth. The research data for AMH in particular are contradictory with a plethora of positive studies but also some that highlight other prognostic indicators, such as the age of the patient, to be superior to it. Serum AMH levels appear to be a useful factor in predicting pregnancy outcome in patients with PCOS before the start of the IVM cycle. AMH can serve as a tool in pre-treatment counseling for the chances of giving birth to a live baby in women with extremely low ovarian reserve. In addition the impact of the high sperm DNA fragmentation rate on the outcome of normal IVF is particularly pronounced when the partner has relatively low AMH levels. Existing predictive models of live birth in IVF include AMH in their algorithm in combination with other factors to provide proper counseling to the couple and the formation of realistic expectations.
CONCLUSIONS: AMH is currently considered a first-line test for assessing ovarian reserve and is considered clinically relevant by the majority of IVF providers, but appears to play a minor role in improving the frequency of live birth rate.
Main subject category:
AMH, IVF, LBR, Biomarkers, Ovarian reserve
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