Undetectable Serum Levels of Anti-Müllerian Hormone in Women with Ovarian Hyperstimulation Syndrome During In Vitro Fertilization and Successful Pregnancy Outcome: Case Report

Abstract

We report a unique case of undetectable serum levels of anti-müllerian hormone (AMH) in women with polycystic ovary syndrome (PCOS) who developed ovarian hyperstimulation syndrome (OHSS) during in vitro fertilization (IVF). A case is described of a 28-year-old woman with clinical symptoms of PCOS and AMH serum level below analytical sensitivity (<1.0 pmol/L). After undergoing controlled ovarian stimulation, the patient developed OHSS. After follicle aspiration, seven oocytes were recovered. Three of them were used for intracytoplasmic sperm injection (ICSI) and fertilized, but with unsuccessful pregnancy outcome. A successful pregnancy was achieved in the second IVF/ICSI cycle with six oocytes retrieved and three embryos transferred. At 39 weeks of gestation, the patient delivered a healthy baby weighing 3930 g and 50 cm long. In conclusion, although AMH is considered a useful tool in ovarian reserve assessment and in predicting response to controlled ovarian hyperstimulation, the case presented shows that AMH should not be used as an independent ovarian marker.

Keywords: Anti-müllerian hormone; Case reports; Infertility; Ovarian hyperstimulation syndrome; Polycystic ovary syndrome; Reproductive techniques, assisted.