P-68: The Relationship between Antimullerian Hormon, Androgens Levels in Serum, Follicular Fluid and IVF Outcome

Background: Anti-mullerian hormone (AMH) could be involved in the abnormal folliculogenesis in the polycystic ovary syndrome which affects 5-10% of women of reproductive age worldwide and is the most common cause of oligoanovulation , infertility , and hyperandrogenism. Materials and Methods: A prospective study included 66 women aged 21-24 years referred for in vitro fertilization (IVF) ,26 patients with polycystic ovary syndrome (PCOS) and 42 patients with normal ovulatory function. On the cycle day 3 , serum samples and on the day of oocyte retrieval follicular fluid (FF) were collected from both group for AMH levels measurements using ELISA. The relationship between serum or FF AMH levels and testosterone (T) ,progesterone (P4) and esteradiol (E2) levels and IVF outcomes including oocytes retrieved, oocyte maturation rate, fertilization rate, implantation rate, high quality grade embryo rate, biochemical and clinical pregnancy rates were further assessed. Results: Median serum basal AMH (ng/ml) [median 14.2 vs. 3.2, p<0.001] or FF AMH (ng/g protein)[median 8.2 vs. 4.7, p<0.01] levels were significantly higher in the PCOS group. In both groups, serum basal AMH levels showed a positive correlation with oocyte retrieved (r=0.323; p=0.037 in control vs. r=0.529; p=0.005 in PCOS). In control group, there was a positive relationship between serum basal AMH levels and percentage of mature oocytes (r=0.331; p=0.032) and implantation rate (r=0.305; p=0.05).The hormonal values of the AMH ,E2,P4 in FF were higher in PCOS than control group, but the T levels in FF of control group are higher than PCOS group. There was a significant relationship between AMH (p<0.05), E2 (p<0.001), P4 (p<0.001), T (p<0.001) in FF between control and PCOS group. Conclusion: FF T has negative and significant correlation with percent of fertilized oocyte in PCOS. The serum basal AMH levels showed a positive correlation with implantation rate and biochemical pregnancy rate in control but not in PCOS group.With increasing levels of T in serum & FF the rate of clinical pregnancy decrease in PCOS & in control group . But the higher levels of serum T with lower levels in FF was associated with more clinical pregnancy rate.