Anti-Müllerian hormone is an independent marker for oocyte survival after vitrification

ABSTRACT

Research question: In this study, correlation between Anti-Müllerian hormone (AMH) and oocyte survival after vitrification is explored. Association between AMH and blastocyst formation after oocyte vitrification is also assessed.

Design: Retrospective observational analysis performed in private IVF centre. 4507 MII warmed oocytes were included from 450 couples, predominantly of Arab ethnicity.Couples underwent 484 ICSI treatments with previous stimulations for oocyte vitrification, between August 2015 and August 2018.

Results: Patient median age was 36,2±6,1 years, AMH 2,6±3,4 ng/mL and body mass index (BMI) 26,1±4,4 Kg/m2. Oocyte survival rate after vitrification was 87,4±20,4%.AMH showed a significant correlation (Tau´s Kendall=0,087, p=0,0079) with oocyte survival rate independent of oocyte yield. Correlation was significant (OR=1,041, p=0,018) when a multivariant model was performed including AMH, age and BMI. A ROC curve was performed and AMH cut-off value to obtain at least 70% survival rate was 1.09 ng/mL with an AUC=0.669.Regarding embryo development in cycles including fresh and warmed oocytes for the same patient, blastocyst formation was higher in fresh compared to warmed oocytes (p<0,001). No significant correlation was seen between fertilization or blastocyst rate with AMH. 

Conclusions: AMH shows a significant correlation with oocyte survival. Blastocyst formation is significantly lower after oocyte vitrification, but no correlation was found with AMH. Clinicians should evaluate oocyte vitrification carefully for patients with AMH below 1,09 ng/mL and consider embryo accumulation for these patients in preference to oocyte accumulation.