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. 2013 Jan 7;6(1):3.
doi: 10.1186/1757-2215-6-3.

External validation of anti-Müllerian hormone based prediction of live birth in assisted conception

Amani Khader  1 , Suzanne M Lloyd, Alex McConnachie, Richard Fleming, Valentina Grisendi, Antonio La Marca, Scott M Nelson
Affiliations

External validation of anti-Müllerian hormone based prediction of live birth in assisted conception

Amani Khader et al. J Ovarian Res. .

Abstract

Background: Chronological age and oocyte yield are independent determinants of live birth in assisted conception. Anti-Müllerian hormone (AMH) is strongly associated with oocyte yield after controlled ovarian stimulation. We have previously assessed the ability of AMH and age to independently predict live birth in an Italian assisted conception cohort. Herein we report the external validation of the nomogram in 822 UK first in vitro fertilization (IVF) cycles.

Methods: Retrospective cohort consisting of 822 patients undergoing their first IVF treatment cycle at Glasgow Centre for Reproductive Medicine. Analyses were restricted to women aged between 25 and 42 years of age. All women had an AMH measured prior to commencing their first IVF cycle. The performance of the model was assessed; discrimination by the area under the receiver operator curve (ROCAUC) and model calibration by the predicted probability versus observed probability.

Results: Live births occurred in 29.4% of the cohort. The observed and predicted outcomes showed no evidence of miscalibration (p = 0.188). The ROCAUC was 0.64 (95% CI: 0.60, 0.68), suggesting moderate and similar discrimination to the original model. The ROCAUC for a continuous model of age and AMH was 0.65 (95% CI 0.61, 0.69), suggesting that the original categories of AMH were appropriate.

Conclusions: We confirm by external validation that AMH and age are independent predictors of live birth. Although the confidence intervals for each category are wide, our results support the assessment of AMH in larger cohorts with detailed baseline phenotyping for live birth prediction.

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Figures

Figure 1
Figure 1
Top panel: Plot of observed/predicted probabilities of a live birth with 95% confidence intervals. No data met the criteria for group seven. Lower panel: Calibration plot of the predicted probability versus observed probability of live birth for the nine groups, with a line of equality. In the figure the point corresponding to zero refers to the category for which no patients met the appropriate age and AMH criteria.
See this image and copyright information in PMC

References

    1. Sunkara SK, Rittenberg V, Raine-Fenning N, Bhattacharya S, Zamora J, Coomarasamy A. Association between the number of eggs and live birth in IVF treatment: an analysis of 400 135 treatment cycles. Hum Reprod. 2011;26:1768–1774. doi: 10.1093/humrep/der106. - DOI - PubMed
    1. La Marca A, Sighinolfi G, Radi D, Argento C, Baraldi E, Artenisio AC, Stabile G, Volpe A. Anti-Mullerian hormone (AMH) as a predictive marker in assisted reproductive technology (ART) Hum Reprod Update. 2010;16:113–130. doi: 10.1093/humupd/dmp036. - DOI - PubMed
    1. Nelson SM, Yates RW, Fleming R. Serum anti-Mullerian hormone and FSH: prediction of live birth and extremes of response in stimulated cycles implications for individualization of therapy. Hum Reprod. 2007;22:2414–2421. doi: 10.1093/humrep/dem204. - DOI - PubMed
    1. Lee TH, Liu CH, Huang CC, Hsieh KC, Lin PM, Lee MS. Impact of female age and male infertility on ovarian reserve markers to predict outcome of assisted reproduction technology cycles. Reprod Biol Endocrinol. 2009;7:100. doi: 10.1186/1477-7827-7-100. - DOI - PMC - PubMed
    1. Li HW, Biu Yeung WS, Lan Lau EY, Ho PC, Ng EH. Evaluating the performance of serum antimullerian hormone concentration in predicting the live birth rate of controlled ovarian stimulation and intrauterine insemination. Fertil Steril. 2010;94:2177–2181. doi: 10.1016/j.fertnstert.2009.12.059. - DOI - PubMed

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