Optimal Anti-Müllerian Hormone in Oocyte Donors: a national database analysis

To study the relationship between high anti-Müllerian hormone (AMH) level in oocyte donors and embryo development and pregnancy outcomes among donor oocyte recipients.Retrospective cohort study SETTING: Donor Egg Bank Database SUBJECTS: Patients undergoing in-vitro fertilization (IVF) using vitrified donor oocytes from 35 IVF centers in the United States between 2013-2021. For each recipient, the first oocyte lot that was received with a planned insemination and embryo transfer, was included.Oocyte donor-recipient cycles MAIN OUTCOME MEASURES: Ongoing pregnancy rate per embryo transfer RESULTS: A total of 3,871 donor oocyte-recipient thaw cycles were analysed. Based on donor AMH serum concentration, cycles were stratified into (1) high AMH group (AMH ≥5 ng/mL; n=1,821) and (2) referent group (AMH <5ng/mL; n=2,050). Generalized estimating equation models were used to account for donors that contributed more than one lot of oocytes. The number of usable embryos per lot [median (IQR)] was significantly increased in the high AMH group [2 (2-4)] compared to the referent group [2 (1-3)] [Relative risk (RR) 1.06; CI 1.01-1.12]. Among recipients with a planned embryo transfer, there was no difference in ongoing pregnancy rate between the high AMH group (45.4%) and the referent group (43.5%) [RR 1.04; 95 % CI 0.94-1.15]. Among PGT-A cycles, embryo euploidy rate per biopsy was similar at 66.7% (50-100%) in both groups [RR 1.04; CI 0.92-1.17]. Ongoing pregnancy rate per euploid embryo transfer among patients who utilized PGT-A was also comparable at 52% in high AMH group and 54.1% in referent group [RR 0.95; CI 0.74-1.23].This large national database study observed that there was no association between a high level of AMH (≥5 ng/mL) in oocyte donors and ongoing pregnancy rate in the recipient following the first embryo transfer. Based on these findings, recipients and physicians can be reassured that oocyte donors with a high AMH level can be expected to produce outcomes that are at least as good as donors with an AMH level <5 ng/mL.