To investigate the correlation between the levels of anti-Müllerian hormone (AMH) in serum and follicular fluid and the number of high-quality embryos in a single ovulation cycle, the pregnancy outcome of fresh cycle transplantation and cumulative pregnancy outcome in patients with different ovarian response.

Totally 714 patients who underwent in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET) in the Reproductive Medical Center, Department of Obstetrics and Gynecology of Peking University Third Hospital from October 2017 to January 2018 were retrospectively analyzed. Clinical data and follicular fluid on the day of oocyte collection were collected for AMH detection. According to the ovarian response, they were divided into three groups: 401 cases in the normal ovarian response group, 124 cases in the low ovarian response group and 189 cases in the high ovarian response group. The general clinical characteristics, basic serum AMH and follicular fluid AMH level on the day of oocyte collection, the number of high-quality embryos, pregnancy rate and live birth rate of fresh cycle transfer, cumulative pregnancy rate and cumulative live birth rate were compared, and the related influencing factors of IVF outcome were analyzed.

The basic serum AMH and follicular fluid AMH of the low ovarian response group, the normal ovarian response group and the high ovarian response group were (0.71±0.77) μg/L, (2.72±3.02) μg/L, (5.90±4.42) μg/L and (3.31±3.37) μg/L, (4.43±5.03) μg/L, (6.20±5.37) μg/L, respectively, the differences were statistically significant (all P<0.001). The cumulative pregnancy rate and the cumulative live birth rate of a single ovulation cycle in the low ovarian response group and the normal ovarian response group were 21.31% (13/61), 41.18% (140/340) and 16.39% (10/61), 36.76% (125/340), respectively, with statistical significances (all P<0.001), while the differences between the high ovarian response group and the normal response group were not statistically significant (all P>0.05). The effects of age and serum AMH (P=0.045, P=0.017), age and follicular fluid AMH (P<0.001, P=0.026) on the number of high-quality embryos in the normal ovarian response group were statistically significant. Follicular fluid AMH was the influencing factor of fresh cycle transplantation pregnancy rate and cumulative pregnancy rate in the normal ovarian response group (P=0.009, P=0.047), the follicular fluid AMH cut-off value was 3.50 μg/L.

Age, serum and follicular fluid AMH were the influencing factors of the number of high-quality embryos in the normal ovarian response group. Follicular fluid AMH was the influencing factor of the fresh cycle and cumulative pregnancy rate in the normal ovarian response group.

Pregnancy rate; Anti-Müllerian hormone; Follicular fluid; Fertilization in vitro; Embryo transfer