Undetectable serum anti-Mullerian hormone levels and occurrence of ongoing pregnancy

Objective: To discuss, on the basis of the experience of two clinical cases and extensive literature review, the significance of extremely low levels of anti-Mullerian hormone (AMH), also known as Mullerian-inhibiting substance, in infertile women. Design: Case report. Setting: University-based infertility clinic at a medical center in Switzerland. Patient(s): Two women, 29 and 41 years of age and with a 2- and 4-year history of secondary infertility, respectively. Intervention(s): Clinical, radiological, and biological investigation of infertility, including repeated measurements of the serum AMH with serial ELISA assays. Main Outcome Measure(s): Levels of AMH and development of ongoing pregnancy. Result(s): Both women had a spontaneous ongoing pregnancy despite undetectable AMH levels. Conclusion(s): Although it is helpful for day-to-day management of infertile patients, the predictive value of AMH for the occurrence of a spontaneous ongoing pregnancy has limits. (Fertil Steril (R) 2008;89:723. e9-11. (C) 2008 by American Society for Reproductive Medicine.)