Serum AMH may be correlated with aneuploidy in a subpopulation of women experiencing infertility

Anti-mullerian hormone (AMH) is produced by granulosa cells of pre-antral and small antral follicles in the ovary. Serum level of AMH reflects the resting follicular pool and has clinical utility in the assessment of ovarian reserve. As such, there is a clear relationship between age and AMH: as age increases, AMH decreases. However, age-specific levels and the rate of AMH decline vary widely between women. The incidence of aneuploidy in embryos also increases with maternal age, but there appears to be less variability between women of the same age than AMH levels. The objective of this study was to characterize the relationship between serum AMH level and aneuploidy assessed by pre-implantation genetic screening (array-CGH) in a population of infertile women. Retrospective cohort study evaluating IVF cycles were PGS was performed between 2008 to 2014. Only cycles meeting our inclusion criteria were analyzed. All embryos analyzed had their trophectoderm biopsied 5 or 6 days after oocyte retrieval. Preimplantation genetic screening (PGS) with array-comparative genomic hybridization (a-CGH) analysis was used to determine whether embryos were euploid prior to transfer. This retrospective study evaluated patients attending one university-affiliated fertility clinic. A logistic regression analysis was used to determine the relationship between AMH levels and proportion of euploid embryos, while controlling for age, parity, BMI, and antral follicle count. There were 158 cycles analyzed. AMH level was correlated with proportion of euploid embryos after controlling for age, parity, BMI, and AFC (p = 0.0045) or without AFC (p=0.007). After stratifying patients by age, there was a correlation between age and proportion of euploid embryos in patients younger than 36 years of age (p =0.015) and patients 36-40 years of age (p = 0.019), but not in patients older than 40 years (p = 0.79). The proportion of euploid embryos is correlated with AMH, except in patients above 40 years. Thus, AMH levels may be helpful in assessing the quality of oocytes, in addition to their quantity (i.e. ovarian reserve).