Age-specific definition of low anti-Mullerian hormone and associated pregnancy outcome in women undergoing IVF treatment

BACKGROUND: The age-specific definition of low anti-müllerian hormone (AMH) is lacking. This study aims to define an age-specific reference for low AMH and to evaluate the associated outcome in women undergoing IVF treatment. METHODS: A retrospective study was performed in women receiving IVF treatment at the Shenzhen maternity and child healthcare hospital between September 2016 and September 2018. We excluded cases without AMH concentration. Polynomial least-squares regression was used to estimate the age-specific reference ranges for AMH after log-transformed. The age-specific 10(th) centile was defined as the threshold of low AMH concentration. RESULTS: A total of 909 patients were analyzed in this study. The age-specific reference ranges for AMH were established using linear regression model and resulted in an age-specific equation for mean: mean of LnAMH = (− 0.085 × age) + 3.722 (ng/ml, in unit). Women with AMH level higher than 10(th) centile had favorable outcomes in ovarian stimulation compared to those with low AMH level. In patients younger than 35 years, the rates of clinical pregnancy per transfer and ongoing pregnancy per transfer in the subgroup with AMH level higher than 10(th) centile were significantly higher than that in the subgroup of low AMH level, 57% versus 31.3% p = 0.003 and 51.9% versus 21.9% p = 0.001, respectively. CONCLUSION: Women with AMH lower than age-specific 10(th) centile had significantly unfavorable outcomes after IVF treatment. The age-specific 10(th) centile of AMH concentration may be useful to predict the outcome of IVF treatment.