Female age, serum antimüllerian hormone level, and number of oocytes affect the rate and number of euploid blastocysts in in vitro fertilization/intracytoplasmic sperm injection cycles

Abstract

Objective: To study the relative role of female age and ovarian reserve, measured through serum antimüllerian hormone (AMH) in determining the rate and number of euploid blastocysts in in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles.

Design: Retrospective analysis of cycles performed in 2014-2015.

Setting: Tertiary referral IVF center.

Patient(s): A total of 578 infertile couples undergoing IVF/ICSI and preimplantation genetic screening (PGS) analysis.

Interventions(s): All embryos were cultured and biopsied at the blastocyst stage. The method involved whole-genome amplification followed by array comparative genome hybridization. Serum AMH was measured by means of the modified Beckman Coulter AMH Gen II assay.

Main outcome measures: The rate and number of euploid blastocysts and their correlation with ovarian reserve and response to stimulation.

Result(s): The mean (±SD) age of patients was 37.6 ± 4.1 years, and the mean number of blastocysts per patient was 3.1 ± 2. The total number of blastocysts available to the analysis was 1,814, and 36% of them were euploid after PGS. Age and serum AMH were significantly and independently related to the rate of euploid blastocysts available for patients. As an effect of the cohort size, the number of mature oocytes positively affected the total number of euploid blastocysts per patient.

Conclusion(s): A strong positive age-independent relationship between AMH level and the rate of euploid blastocysts was found. This confirms that the measurement of ovarian reserve by means of AMH has high relevance when counseling infertile patients.

Keywords: AMH; IVF/ICSI; euploid blastocyst; female age; mature oocytes.