Anti-Müllerian hormone in guiding the selection of a freeze-all versus a fresh embryo transfer strategy: a cohort study
Date
2022
Authors
Hu, K.-L.
Yang, R.
Xu, H.
Mol, B.W.
Li, R.
Wang, R.
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Journal Title
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Journal article
Citation
Journal of Assisted Reproduction and Genetics, 2022; 39(10):2325-2333
Statement of Responsibility
Kai, Lun Hu, Rui Yang, Huiyu Xu, Ben W. Mol, Rong Li, Rui Wang
Conference Name
Abstract
Purpose: To explore an interaction effect between serum anti-Müllerian hormone (AMH) levels and the relative treatment effect of a freeze-all versus a fresh embryo transfer strategy on live birth. Methods: This was a retrospective cohort study investigating couples with infertility and eligible for both freeze-all and fresh embryo transfer between 2017 and 2019. Women with an absolute indication for a freeze-all strategy were excluded. Multivariable fractional polynomial interaction analysis within a logistic regression model was used to evaluate whether the treatment effect of a freeze-all versus a fresh transfer strategy varied at different AMH levels. Non-linear interactions were also considered. The primary outcome was the live birth after the first transfer. Results: A total of 13,503 women underwent a fresh embryo transfer and 2247 women underwent a freeze-all strategy. Live birth rates were slightly higher in the freeze-all group compared to those in the fresh embryo transfer group (35% vs 33%). There was a non-linear interaction between baseline serum AMH levels and the relative treatment effect of a freeze-all strategy versus a fresh transfer strategy on live birth (P = 0.0161). The benefit on live birth from a freeze-all embryo transfer strategy was greatest in women with a high serum level (> 7 ng/ml). The interaction remained valid when different imputation methods were used. Conclusion: As serum AMH level increased, there was a nonlinear increase in relative treatment effect of a freeze-only transfer versus a fresh transfer strategy on live birth, and such an effect reaches its maximum in women with high AMH levels.
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Dissertation Note
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Published online: 23 July 2022
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© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022