Association Between Anti-Müllerian Hormone Levels and Intrauterine Insemination Outcomes Across Different Ovarian Stimulation Protocols

Background & Objective: Intrauterine Insemination (IUI) is a commonly used treatment of infertility. Anti-Müllerian Hormone (AMH), produced by growing ovarian follicles, is a reliable marker of ovarian reserve. This study was conducted with aim to investigate the association between AMH levels and pregnancy outcomes in women undergoing IUI with ovarian stimulation.Materials & Methods: This retrospective study was conducted on 104 infertile patients undergoing IUI at Dr. Hasan Sadikin Hospital, Bandung, from 2017 to 2021. Eligible women had age 20-35 years with unexplained infertility, mild endometriosis, or mild male factor infertility, and at least one patent fallopian tube. Natural cycle IUI and incomplete records were excluded. AMH levels were measured at cycle start and stratified into five categories: <1, 1-2, 2-3, 3-5, and >5 ng/mL. Stimulation protocols included Clomiphene Citrate (CC), recombinant Follicle-Stimulating Hormone (rFSH), or a combination. Clinical pregnancy was confirmed by serum β-hCG 14 days after IUI. Data was analyzed using SPSS software (version 26.0) and Chi-square test. P<0.05 was considered significant.Results: The overall clinical pregnancy rate was 36.5%. A significant association was found between AMH levels and pregnancy outcome in the rFSH group (P=0.036) and the CC + rFSH group (P=0.026), with higher AMH correlated with increased pregnancy rates. No significant association was observed in the CC-only group (P=0.613).Conclusion: AMH level may serve as a useful predictor of IUI success in gonadotropin-containing protocols but appears less predictive in CC-only cycles.