Impact of anti-Müllerian hormone and antral follicle count discordance on elective fertility preservation outcomes.
Level 3 - non-randomized controlled study
Retrospective cohort study
PubMed 42281451 · doi:10.1002/ijgo.71115
What was done
A retrospective cohort study evaluated 230 healthy women aged 30–41 years undergoing their first elective fertility preservation (EFP) cycle at a university-affiliated tertiary fertility unit. Participants were categorized into concordant and discordant groups using thresholds for anti-Müllerian hormone (AMH <1.1 or ≥1.1 ng/mL) and antral follicle count (AFC <7 or ≥7). Multivariable linear regression evaluated independent predictors of retrieved and vitrified oocyte counts.
What was found
The overall AMH-AFC discordance rate was 30.43%. Women with normal AFC (≥7) but low AMH (<1.1 ng/mL) (n = 67) had significantly fewer retrieved oocytes (mean 6.7 ± 4.5 vs. 14.6 ± 8.1; P < 0.001) and vitrified oocytes (mean 4.9 ± 3.4 vs. 10.6 ± 6.8; P < 0.001) compared to women with normal AFC and normal AMH (n = 149). AMH was the strongest independent predictor of oocyte yield. While discordance independently predicted fewer retrieved oocytes compared to concordant-normal profiles, concordance status was not an independent predictor of the number of vitrified oocytes.
Why it matters
This study shows that relying solely on a normal antral follicle count may overestimate stimulation response if AMH is low, suggesting that measuring both markers together provides more realistic expectations for patients undergoing elective oocyte cryopreservation.
Limits
The study is limited by its retrospective, single-center design and modest sample size (230 patients). Outcomes for the other two potential concordant/discordant subgroups were not reported in the abstract. Clinical reproductive outcomes, such as post-thaw fertilization, pregnancy, and live birth rates, were not evaluated.
Cited by
- context Each 0.1 ng/mL of anti-Müllerian hormone (AMH) corresponds on average to approximately one ovarian follicle.