Antimüllerian hormone as predictor of reproductive outcome in subfertile women with elevated basal follicle-stimulating hormone levels: a follow-up study.

Objective: To investigate the role of serum antimüllerian hormone (AMH) as a predictor of live birth and reproductive stage in subfertile women with elevated basal FSH levels.

Design: A prospective observational cohort study conducted between February 2005 and June 2009.

Setting: Tertiary fertility center.

Patient(s): Subfertile women with [1] a regular menstrual cycle (mean cycle length 25-35 days); [2] basal FSH concentrations ≥12.3 IU/L; and [3] younger than 40 years (n = 96).

Intervention(s): None.

Main Outcome Measure(s): Live birth and reproductive stage according to the Stages of Reproductive Aging Workshop.

Result(s): A cumulative live birth rate of 63.5% was observed during a median follow-up of 3.3 years (n = 85). The AMH level was significantly associated with live birth. There was evidence of a nonlinear prediction pattern, with an increase in chances of live birth until an AMH level of 1 μg/L. Other ovarian reserve tests and chronological age appeared of limited value in predicting live birth. In addition, AMH was significantly associated with the timing of reproductive stages (n = 68) (i.e., the occurrence of menopausal transition or menopause during follow-up).

Conclusion(s): The present findings suggest applicability of AMH determination as a marker for actual fertility in subfertile women with elevated basal FSH levels.