***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Abstract Objective : To estimate the association between maternal age and fetal death ( spontaneous abortion , ectopic pregnancy , stillbirth ) , taking into account a woman 's reproductive history . Design : Prospect i ve register linkage study . Subjects : All women with a reproductive outcome ( live birth , stillbirth , spontaneous abortion leading to admission to hospital , induced abortion , ectopic pregnancy , or hydatidiform mole ) in Denmark from 1978 to 1992 ; a total of 634 272 women and 1 221 546 pregnancy outcomes . Main outcome measures : Age related risk of fetal loss , ectopic pregnancy , and stillbirth , and age related risk of spontaneous abortion stratified according to parity and previous spontaneous abortions . Results : Overall , 13.5 % of the pregnancies intended to be carried to term ended with fetal loss . At age 42 years , more than half of such pregnancies result ed in fetal loss . The risk of a spontaneous abortion was 8.9 % in women aged 20–24 years and 74.7 % in those aged 45 years or more . High maternal age was a significant risk factor for spontaneous abortion irrespective of the number of previous miscarriages , parity , or calendar period . The risk of an ectopic pregnancy and stillbirth also increased with increasing maternal age . Conclusions : Fetal loss is high in women in their late 30s or older , irrespective of reproductive history . This should be taken into consideration in pregnancy planning and counselling OBJECTIVE To test whether the follicular fluid ( FF ) concentration of anti-Mullerian hormone ( AMH ) is associated with oocyte maturation , fertilization rate , and embryonic development in patients with polycystic ovary syndrome ( PCOS ) undergoing IVF .  DESIGN Prospect i ve . SETTING Academic assisted reproductive technology program . PATIENT(S ) Twenty-two sample s of FF from 11 patients with PCOS who underwent IVF/ET  were analyzed for AMH levels ( group A ) . Twelve women with normal ovulatory cycles served as a control group ( group B ) . The oocytes and preembryos were closely followed until ET . METHOD ( S ) FF was obtained at oocyte retrieval for IVF/intracytoplasmic sperm injection . AMH levels were studied using immunoenzymometric assay . INTERVENTION(S ) None . MAIN OUTCOME MEASURE(S ) FF , AMH levels , oocyte maturation , fertility rate , and embryonic cleavage rate . RESULT ( S ) The mean FF AMH level was 57.3 + /- 79.5 pmol/mL in group A , compared with 70 + /- 120.14 pmol/mL in group B. In group A , the mean AMH level of good- quality embryos was 37.4 + /- 23.4 pmol/mL , compared with 61.9 + /- 102 pmol/mL in a the poor- quality subgroup . No significant correlation was observed between FF AMH levels and oocyte maturation , fertilization , or cleavage rate . CONCLUSION ( S ) This study suggests that there is an association between FF AMH levels and the quality of embryos in patients with PCOS . However , owing to large variance and the number of participants , no statistical significance was reached . The degree of maturation of retrieved oocytes , as well as the success of fertilization , was not found to correlate with FF AMH BACKGROUND Individualization of controlled ovarian stimulation ( COS ) for assisted conception is complicated by variable ovarian response to follicle stimulating hormone . We hypothesized that anti-Müllerian hormone ( AMH ) , a predictor of oocyte yield , may facilitate treatment strategies for women undergoing COS  , to optimize safety and clinical pregnancy rates . METHODS Prospect i ve cohort study of 538 patients in two centres with differential COS strategies based on a central ized AMH measurement . RESULTS AMH was associated with oocyte yield after ovarian stimulation in both centres , and a ' reduced ' AMH ( 1 to < 5 pmol/l ) was associated with a reduced clinical pregnancy rate .  Women with a ' normal ' AMH ( 5 to < 15 pmol/l ) treated with a  long GnRH-agonist protocol  ( both centres ) showed a low incidence of excess response ( 0 % ) and poor response ( 0 % ) . In women with ' high ' AMH ( > 15 pmol/l ) , the antagonist protocol eliminated the need for complete cryopreservation of embryos due to excess response ( P < 0.001 ) and showed a higher fresh cycle clinical pregnancy rate than agonist cycles [ OR 4.40 ( 95 % CI 1.95 - 9.93 ) , P < 0.001 ] . CONCLUSIONS The use of circulating AMH to individualize treatment strategies for COS may result in reduced clinical risk , optimized treatment burden and maintained pregnancy rates , and is worthy of prospect i ve r and omized examination Purpose The objective of this study was to investigate the predictive value of anti-Mullerian hormone ( AMH ) on fertilization rate ( FR ) , blastocyst development , embryo quality , the outcome of the pregnancy and the live birth rate ( LBR ) following in vitro fertilization-embryo transfer (IVF-ET)/intracytoplasmic sperm injection ( ICSI ) . Method In this prospect i ve study outcomes were followed in 83 women undergoing cycles of IVF/ICSI within a university hospital .  Basal serum AMH , follicle stimulating hormone ( FSH ) , luteinizing hormone ( LH ) and antral follicle count ( AFC ) were measured on Day 3 .  Serum AMH ( Gn6 AMH ) level was measured on Day 6 after the administration of gonadotrophin ( Gn ) . AMH was measured in follicle fluid ( FF AMH ) on the day of ovum pick-up ( dOPU ) . The numbers of retrieved and fertilized oocytes , good quality embryos and blastocysts were counted . Secondary outcome variables included clinical pregnancy rate ( CPR ) and LBR . Results Spearman correlation analysis indicated that the numbers of oocytes , good quality embryos and blastocysts were associated with AMH ( P < 0.05 ) and that LBR was correlated with FF AMH ( r = 0.495 , P < 0.05 ) . No associations were found between FR and AMH ( P > 0.05 ) . Receiver operating characteristic analysis showed that the sensitivity of FF AMH at predicting CPR was 91.2 % ; the specificity was 86.5 % and ROCAUC was 0.893 ( P < 0.0001 ) . Conclusion AMH parameters were correlated with good quality embryos and blastocysts , but only FF AMH showed a significant correlation with LBR and CPR The chance of infertile patients conceiving is related to factors like female age and duration of infertility . This prospect i ve observational study evaluated whether the results of ovarian reserve tests , including the novel marker serum anti-Mullerian hormone ( AMH ) , were of additional value in predicting ongoing pregnancy .  Two hundred and twenty-two patients diagnosed with unexplained infertility or mild male factor ( total motile count>10x10(6 ) ) on the basis of the infertility work-up were prospect ively included .  Antral follicle count , AMH , inhibin B , FSH and oestradiol concentrations were determined during the early follicular phase . Outcome measures were treatment-dependent and treatment-independent ongoing pregnancy and time to ongoing pregnancy . There were 159 ongoing pregnancies , 52 of which occurred spontaneously . Pregnant patients were significantly younger than those who did not become pregnant ( median age 32.4 versus 34.9 years , P<0.001 ) and FSH concentrations were higher in non-pregnant patients ( median 6.8 versus 7.6 IU/l , P=0.04 ) . Only age ( hazard ratio 0.93 , 95 % CI 0.90 - 0.97 ) and whether or not the patient was undergoing treatment ( hazard ratio 8.10 , 95 % CI 5.66 - 11.61 ) were significantly associated with time to ongoing pregnancy .  Ovarian reserve tests , other than chronological age , seem of limited value in predicting ( time to ) ongoing pregnancy in patients with unexplained and mild male infertility Serum  anti-Müllerian hormone ( AMH ) concentrations decline with increasing age and constitute a sensitive marker for ovarian ageing . In addition , basal serum AMH concentrations predict ovarian response during IVF cycles . Concomitantly , oocyte quantity and embryo quality decrease with advancing age . Hence , it was postulated that AMH in serum constitutes a marker for embryo quality . Women aged 37 years and younger with regular menstrual cycles , normal body mass index and partners with normal semen parameters were r and omly assigned to either a st and ard  or mild stimulation protocol for IVF treatment . Blood sample s were drawn at cycle day 3 and at the day of human chorionic gonadotrophin administration . Embryo quality was assessed using embryo morphology score and preimplantation genetic screening . Serum AMH concentrations on cycle day 3 were correlated with the number of oocytes retrieved in both groups . AMH and embryo morphology were correlated after mild stimulation , but not after conventional ovarian stimulation . AMH and the chromosomal competence of embryos were not correlated . Serum AMH is predictive for ovarian response to stimulation . However , the lack of a consistent correlation with embryo morphology and embryo aneuploidy rate is not in favour of a direct relationship between oocyte quantity and embryo quality Background This study was design ed to assess the capability of ovarian reserve markers , including baseline FSH levels , baseline anti-Müllerian hormone ( AMH ) levels , and antral follicle count ( AFC ) , as predictors of live births during IVF cycles , especially for infertile couples with advanced maternal age and /or male factors . Methods A prospect i ve cohort of 336 first IVF/ICSI cycles undergoing a long protocol with GnRH agonist was investigated . Patients with endocrine disorders or unilateral ovaries were excluded . Results Among the ovarian reserve tests , AMH and age had a greater area under the receiving operating characteristic curve than FSH in predicting live births . Furthermore , AMH and age were the sole predictive factors of live births for women greater than or equal to 35 years of age ; while AMH was the major determinant of live births for infertile couples with absence of male factors by multivariate logistic regression analysis . However , all the studied ovarain reserve tests were not preditive of live births for women < 35 years of age or infertile couples with male factors . Conclusion The serum AMH levels were prognostic for pregnancy outcome for infertile couples with advanced female age or absence of male factors . The predictive capability of ovarian reserve tests is clearly influenced by the etiology of infertility BACKGROUND Serum anti-Müllerian hormone ( AMH ) levels provide a powerful means for predicting ovarian response , which is reflected not only by the size of the primordial follicle pool but also by the quality of the oocytes . Considering a mutual interdependence between AMH-expressing somatic cells and gametes , this prospect i ve morphological study was set up to evaluate whether extreme AMH levels represent diminished oocyte quality and developmental incompetence . METHODS A total of 141 consecutive ICSI patients were subdivided into three groups using the 25th and 75th percentiles of the serum AMH levels ( cycle day 3 ) . In these three groups , morphology of all oocytes and fertilization rate , embryo quality and blastocyst formation were evaluated , and  FSH , LH and estradiol ( E(2 ) ) levels were also measured . RESULTS Cycle cancellation rate was correlated with AMH levels ( P < 0.05 ) . AMH groups 1 ( < 1.66 ng/ml ) and 3 ( > 4.52 ng/ml ) showed oocytes of lower quality [ dark central granulation , aggregation of smooth endoplasmic reticulum ( sER ) ] compared with the median group 2 ( 1.66 - 4.52 ng/ml ) . Basal serum FSH did not allow for adequate prognosis in terms of gamete appearance . Fertilization and further cleavage up to blastocyst stage was not affected by AMH levels . CONCLUSIONS AMH seems to be superior to FSH in predicting both oocyte number and quality OBJECTIVE To investigate whether anti-Müllerian hormone ( AMH ) is better than antral follicle count ( AFC ) in predicting oocyte yield and embryo quality after controlled ovarian hyperstimulation for  in vitro fertilization ( IVF ) . STUDY DESIGN This is a prospect i ve observational study involving 162 women ( < 40 years old ) undergoing their first IVF cycle at an IVF unit within a university hospital .  AMH and AFC measurements were made on day 3 of the cycle within 3 months of starting ovarian stimulation . A st and ard long down-regulation protocol using gonadotrophin releasing hormone agonist and recombinant follicle stimulating hormone was used . A maximum of two embryos were transferred on day 2 or 3 following oocyte retrieval . The primary outcome was the number of good quality embryos available for transfer and freezing . Embryos were grade d according to the number of blastomeres , the difference in blastomere size and the degree of fragmentation 
    Output:
    
AMH , independently of age , has some association with predicting live birth after assisted conception and may be helpful when counselling couples before undergoing fertility treatment .
However , its predictive accuracy is poor