From the Guidelines
AMH levels remain relatively stable during controlled ovarian stimulation (COS), with minor fluctuations that do not significantly impact the overall assessment of ovarian reserve. This stability is due to the fact that AMH is primarily produced by small antral and pre-antral follicles, which are less responsive to gonadotropin stimulation compared to larger follicles 1. The use of medications such as recombinant FSH, GnRH antagonists, and hCG trigger during COS does not substantially alter AMH levels, making it a reliable marker for predicting ovarian response before starting stimulation.
Some key points to consider when interpreting AMH levels during COS include:
- AMH levels reflect the ovarian reserve, which is the pool of remaining follicles in the ovaries 1
- The stability of AMH during COS allows clinicians to rely on pre-stimulation measurements for protocol planning, without needing to reassess AMH during the stimulation cycle
- Minor decreases in AMH during stimulation may occur due to the transition of AMH-producing small follicles to larger follicles that produce less AMH 1
- The consistency of AMH during stimulation contrasts with other hormones like estradiol, which increase dramatically in response to gonadotropins
In clinical practice, the stability of AMH during COS is beneficial for individualizing stimulation protocols and predicting reproductive success measures, including ovarian response to gonadotrophins 1. However, it is essential to consider that AMH levels may not be directly associated with pregnancy and live-birth rates, and other factors such as oocyte quality and embryo aneuploidy may play a more significant role in determining reproductive outcomes 1.
From the Research
AMH Level Changes During Controlled Ovarian Stimulation
- The studies provided do not directly address the changes in Anti-Müllerian Hormone (AMH) levels during controlled ovarian stimulation (COS) 2, 3, 4, 5, 6.
- However, one study mentions that AMH is viewed as the most reliable single marker for estimating ovarian response using the antral follicle count and/or serum anti-Müllerian hormone levels 4.
- Another study discusses the importance of individualizing COS protocols to optimize efficacy and safety, which may involve considering AMH levels, but does not provide information on how AMH levels change during COS 6.
- There is no direct evidence in the provided studies to support a specific answer to the question of how AMH levels change during controlled ovarian stimulation.
Related Findings
- The studies focus on various aspects of controlled ovarian stimulation, including medication protocols, dose adjustments, and predictors of response to COS 2, 3, 5, 6.
- One study found that an elevated FSH/LH ratio was associated with a higher rate of failed COS cycles and required a greater total gonadotropin dosage 5.
- Another study discussed the use of different stimulation protocols, including GnRH agonist and antagonist protocols, and the combination of human-derived urinary FSH and recombinant FSH 6.