Serum Anti-Mullerian hormone and embryo morphokinetics detecting by time-lapse imaging: A comparison between the polycystic ovarian syndrome and tubal factor infertility|
Tabibnejad, Nasim; Soleimani, Mehrdad & Aflatoonian, Abbas
Background: Anti-Mullerian hormone (AMH) is considered as a good marker for
quantitative evaluation of ovarian response to the stimulation during assisted
reproductive technology cycles.
Objective: To evaluate the association between serum AMH level and embryo
morphokinetics using time-lapse imaging and intracytoplasmic sperm injection
(ICSI) outcomes in women with polycystic ovarian syndrome (PCOS).
Materials and Methods: We evaluated a total of 547 embryos from 100 women
underwent ICSI cycles; 50 women with PCOS and 50 women with tubal factor
infertility. Serum AMH level was measured in all participants. Time-laps records
were annotated for time to pronuclear fading (tPNf), time to 2-8 cells (t2-t8), reverse
cleavage, direct cleavage, and also for the presence of multinucleation.
Results: AMH was negatively correlated with t5, t8, and the third cell cycle
(p=0.02, p=0.02, and p=0.01; respectively) in PCOS group. AMH had no correlation
with embryo kinetics in infertile women with tubal factor infertility. Moreover,
AMH level is similar between embryos with and without direct cleavage as well as
reverse cleavage and Multinucleation in both groups. The Receiver operating
characteristic curves analyses indicated that AMH was not an accurate predictor of
clinical pregnancy as well as a live birth (AUC=0.59 [95% CI, 0.42-0.76]) in PCOS
women. However, in the women with tubal factor infertility AMH showed a fair
prediction value for clinical pregnancy (AUC=0.64 [95% CI, 0.48-0.82]) along with
the live birth (AUC=0.70 [95% CI, 0.55-0.85]).
Conclusion: Some of the time-lapse embryo parameters may be related to the AMH
concentration. However, AMH is not an accurate tool to predict the ICSI outcomes
in PCOS women.
Anti-Mullerian hormone; Embryo morphokinetic; Pregnancy outcome; Time-lapse; PCOS.