Assessment of embryological outcomes in IVF programs for patients of different age groups based on AMH levels
Nazarenko T.A., Khachatryan N.A., Krylova E.I., Biryukova A.M.
Objective: To evaluate embryological outcomes of IVF programs by examining the number of high-quality blastocysts in relation to AMH levels across different patient age groups.
Materials and methods: A retrospective analysis was conducted on the clinical and laboratory characteristics and results of IVF programs involving 900 patients treated between 2023 and 2024 at the V.I. Kulakov NMRC for OG&P. The mean age of women in the first group was 29.06 (2.85) years, in the second group was 39.01 (1.94) years, and in the third group was 43.03 (1.17) years.
Results: A low number of oocytes (0–5) was consistently observed in women of an advanced reproductive age. A count of 6–10 oocytes was found with equal frequency in both the older and middle-aged groups, while it was less common among younger women, who had a greater number of oocytes (p<0.001). When analyzing the number of MII oocytes, a similar quantity was noted in both the first and second groups, regardless of the total number of oocytes. The most significant finding was the quality of the blastocysts obtained. In the first and second groups, most blastocysts were of excellent or good quality, whereas in the third group, most were of low quality. The analysis of IVF outcomes in subgroups of patients with decreased ovarian reserve revealed that 67% of younger patients and 52% of middle-aged patients produced high-quality blastocysts, whereas no high-quality embryos were obtained from women of advanced reproductive age.
Conclusion: Even with comparable AMH levels in young and older patients, the proportion of high-quality blastocysts significantly declines with age, approaching zero in women over 40. This decline is likely to be associated with oocyte quality, embryo aneuploidy, and impaired development in older patients. In contrast, younger patients can still achieve high-quality embryos despite indicators of decreased ovarian reserve. These findings support the feasibility of conducting IVF programs to achieve pregnancy in younger patients, even when ovarian reserve is reduced.
Authors' contributions: Nazarenko T.A. – conception and design of the study, editing and final approval of the manuscript; Khachatryan N.A., Krylova E.I., Biryukova A.M. – collection of material, statistical analysis, drafting of the manuscript.
Conflicts of interest: The authors have no conflicts of interest to declare.
Funding: There was no funding for this study.
Ethical Approval: The study was reviewed and approved by the Research Ethics Committee of the V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia.
Patient Consent for Publication: All patients participating in the study signed an informed consent form. They were informed that the study data would be published without their names being used in written reports or publications.
Authors' Data Sharing Statement: The data supporting the findings of this study are available upon request from the corresponding author after approval from the principal investigator.
For citation: Nazarenko T.A., Khachatryan N.A., Krylova E.I., Biryukova A.M. Assessment of
embryological outcomes in IVF programs for patients of different age groups based on AMH levels.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2025; (6): 124-130 (in Russian)
https://dx.doi.org/10.18565/aig.2025.41
Keywords
anti-Müllerian hormone (AMH)
in vitro fertilization (IVF)
ovarian reserve
maternal age
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Received 19.02.2025
Accepted 21.05.2025
About the Authors
Tatyana A. Nazarenko, Dr. Med. Sci., Professor, Head of the Institute of Reproductive Medicine, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparin str., 4, t_nazarenko@oparina4.ru, https://orcid.org/0000-0002-5823-1667Nelli A. Khachatryan, PhD, doctor at the F. Paulsen Research and Educational Center for ART with the Clinical Department, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparin str., 4, n_khachatryan@oparina4.ru
Ekaterina I. Krylova, Resident, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia,
117997, Russia, Moscow, Ac. Oparin str., 4, kr.katrin00@gmail.com, https://orcid.org/0000-0002-0220-0474
Almina M. Biryukova, PhD, Clinical Supervisor at the F. Paulsen Research and Educational Center for ART with the Clinical Department, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparin str., 4, a_birukova@oparina4.ru
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