ABSTRACT

Infertility affects one in six couples worldwide during their reproductive lifetimes. Various tests are used to identify the cause of infertility (sex- or non–sex-specific) and optimize treatment planning. Assisted reproductive therapy (ART) involves ovarian stimulation to obtain multiple oocytes and is increasingly used to help couples conceive. Successful ART relies on patient-tailored doses of follicle-stimulating hormone (FSH), which consider an individual’s characteristics such as body weight and ovarian reserve. The current standard of care for assessment of ovarian reserve is measurement of anti-Müllerian hormone (AMH), which can be quantified by immunoassay or determination of antral follicle counts by transvaginal ultrasonography. AMH levels show low inter- and intramenstrual cycle variation and are therefore a more reliable predictor of response to ovarian stimulation than FSH and estradiol. Indeed, tailoring follitropin delta (novel recombinant human FSH) dosing based on Elecsys® AMH Plus immunoassay measurements and body weight can reduce the chance ovarian responses that are too low or too high, without the need for dose adjustments during stimulation. Compared with the standard of care, this method is non-inferior for pregnancy and implantation rates and is associated with reduced incidence of ovarian hyperstimulation syndrome. Future clinical utility of AMH may include diagnosis of polycystic ovary syndrome.