Correlation between follicular fluid AMH levels and numbers of oocytes in polycystic ovarian syndrome patients undergoing in vitro fertilization

Anti-Mullerian Hormones (AMH) are glycoproteins secreted by the granulosa cells of small antral and pre-antral follicles for the regulation of early follicular development. Impaired folliculogenesis may result in excess accumulation of follicles resulting in increased levels of AMH associated with polycystic ovarian syndrome (PCOS). The numbers of studies on the relationship between the follicular fluid AMH levels and the number of oocytes are limited. In this study, we investigated the correlation between the AMH levels in follicular fluid and the numbers of oocytes in patients with PCOS undergoing in vitro fertilization (IVF). This cross-sectional study was conducted at Yasmin IVF Clinic, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia, between November 2016 and March 2017. Follicular fluid from 20 patients with PCOS aged 27-39 years and who were undergoing IVF were aspirated under transvaginal ultrasound guidance, and their AMH levels were measured using enzyme-linked immunosorbent assay. The correlation between the follicular fluid AMH levels and the number of oocytes was analyzed using Spearman correlation. Increase in the AMH levels in the follicular fluid of patients did not affect the number of oocytes detected (p = 0.862), with a mean AMH level of 5.49 ng/mL associated with 18 oocytes. Despite the lack of statistical significance, the correlation graphic demonstrated a trend of increasing AMH levels with a decreasing number of oocytes (r = -0.041). No correlation was noted between the level of AMH in the follicular fluid and the number of oocytes in the study patients with PCOS. Analysis of a larger sample size is warranted to confirm the current data.