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      High anti-Mullerian hormone level is adversely associated with cumulative live birth rates of two embryo transfers after the first initiated cycle in patients with polycystic ovary syndrome

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          Abstract

          Objective

          Anti-Mullerian hormone (AMH) has been recently identified as a potential predictor of live birth rates (LBRs) following assisted reproductive technology (ART) treatment. This study aimed to investigate the association between AMH levels and the outcomes of in vitro fertilization (IVF) in patients with polycystic ovary syndrome (PCOS).

          Methods

          Patients with PCOS initiating their first ovarian stimulation under the gonadotropin-releasing hormone antagonist protocol at the Guangdong Women and Children Hospital, China, were enrolled from November 2014 to September 2018. A total of 157 patients who underwent fresh embryo transfer (ET) cycles were included in group A, whereas 187 patients who underwent frozen–thawed ET cycles were included in group B. After the failure of the first ET cycle, 94 patients underwent the second ET cycle with frozen–thawed embryos. Of these 94 patients, 52 had failed the first fresh ET cycle (group C) and 42 had failed the first frozen–thawed ET cycle (group D). Successful embryo transfer was defined as live birth. This retrospective cohort study addressed the association between AMH levels and pregnancy outcomes using logistic regression approaches. After adjusting for age, body mass index, antral follicle counts, baseline follicle-stimulating hormone levels and baseline progesterone levels, LBRs were compared among the four groups and the cumulative live birth rate after two embryo transfers (TCLBR) was calculated.

          Results

          The LBRs showed no differences among the four groups. Higher serum AMH levels were found to be associated with a lower TCLBR [adjusted OR 0.937 (0.888–0.987), P = 0.015]. In patients who underwent the second ET cycle, LBRs were inversely proportional to AMH levels [crude OR 0.904 (0.828–0.986), P = 0.022 versus adjusted OR 0.845 (0.754–0.946), P = 0.004, respectively]. In addition, the LBR was approximately 61%–78% lower in the group with AMH levels of >12 ng/mL [crude OR 0.391 (0.168–0.912), P = 0.030 versus adjusted OR 0.217 (0.074–0.635), P = 0.005, respectively].

          Conclusions

          Among PCOS patients high AMH level (>12 ng/ml) is found to be associated with low TCLBR and low LBR of the second embryo transfer cycles. The results provide limited clinical inferences and warrant further investigation.

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          Most cited references32

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          Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome

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            The Istanbul consensus workshop on embryo assessment: proceedings of an expert meeting.

            Many variations in oocyte and embryo grading make inter-laboratory comparisons extremely difficult. This paper reports the proceedings of an international consensus meeting on oocyte and embryo morphology assessment. Background presentations about current practice were given. The expert panel developed a set of consensus points to define the minimum criteria for oocyte and embryo morphology assessment. It is expected that the definition of common terminology and standardization of laboratory practice related to embryo morphology assessment will result in more effective comparisons of treatment outcomes. This document is intended to be referenced as a global consensus to allow standardized reporting of the minimum data set required for the accurate description of embryo development.
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              Criteria, prevalence, and phenotypes of polycystic ovary syndrome.

              Polycystic ovary syndrome (PCOS) is a highly prevalent disorder effecting reproductive-aged women worldwide. This article addresses the evolution of the criteria used to diagnosis PCOS; reviews recent advances in the phenotypic approach, specifically in the context of the extended Rotterdam criteria; discusses limitations of the current criteria used to diagnosis, particularly when studying adolescents and women in the peri- and postmenopause; and describes significant strides made in understanding the epidemiology of PCOS. This review recognizes that although there is a high prevalence of PCOS, there is increased variability when using Rotterdam 2003 criteria, owing to limitations in population sampling and approaches used to define PCOS phenotypes. Last, we discuss the distribution of PCOS phenotypes, their morbidity, and the role that referral bias plays in the epidemiology of this syndrome.
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                Author and article information

                Contributors
                Journal
                Front Endocrinol (Lausanne)
                Front Endocrinol (Lausanne)
                Front. Endocrinol.
                Frontiers in Endocrinology
                Frontiers Media S.A.
                1664-2392
                14 June 2023
                2023
                : 14
                : 1123125
                Affiliations
                [1] 1 Department of Reproductive Health and Infertility, Guangdong Province Women and Children Hospital , Guangzhou, China
                [2] 2 The First Clinical Medical School of Guangzhou University of Chinese Medicine , Guangzhou, China
                [3] 3 Department of Gynecology, First Affiliated Hospital of Guangzhou University of Chinese Medicine , Guangzhou, China
                Author notes

                Edited by: Huixia Yang, Peking University, China

                Reviewed by: Shuo Yang, Peking University Third Hospital, China; Yujia Zhang, Centers for Disease Control and Prevention (CDC), United States

                *Correspondence: Fenghua Liu, liushine2006@ 123456163.com

                †These authors have contributed equally to this work and share first authorship

                Article
                10.3389/fendo.2023.1123125
                10305806
                37388214
                8131606f-03c5-405b-95d4-8b7611e8a36e
                Copyright © 2023 Su, Zhan, Xie, Zhao, Huang, Wang, Liao, Zhang and Liu

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 13 December 2022
                : 23 May 2023
                Page count
                Figures: 3, Tables: 4, Equations: 0, References: 32, Pages: 11, Words: 5692
                Funding
                This study was supported by Guangdong Province Weiji Medical Develop’s Fund (No.: K-202104-2) and Science and Technology Program of Guangzhou, China (Nos.: 202102080021, 202102080367, 202102080432 and 202102080503).
                Categories
                Endocrinology
                Original Research
                Custom metadata
                Reproduction

                Endocrinology & Diabetes
                anti-mullerian hormone,polycystic ovary syndrome,embryo transfer,live birth,pregnancy outcome,assisted reproductive technology,fitting curve

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