Introduction: The role of AMH in the ovary is to participate in the regulation of ovarian function, 
especially in follicle development and selection. It inhibits the initiation of human primordial follicle 
growth and prevents multiple selection of a dominant follicle by reducing the sensitivity of follicles to 
follicle stimulating hormone (FSH). Several reports suggest that AMH might be a better predictor of 
ovarian responses to controlled ovarian hyperstimulation (COS) than traditional parameters such as age, 
FSH, estradiol (E2) and inhibin B (INH-B). So, the objective of this study was to investigate the predictive 
value of anti-Mullerian hormone (AMH) on fertilization rate (FR), implantation rate, blastocyst 
development, embryo quality, chemical pregnancy, clinical pregnancy and ongoing pregnancy after ICSI.
Method: In this prospective clinical trial outcomes were followed in 60 women undergoing cycles of 
IVF/ICSI within El-Minia university hospital. AMH concentration was estimated in pooled FF on day of 
oocyte pickup. Cycles were sorted into low and high groups according to median (50 th centile) values of 
measurement. The fertilization rate (FR), implantation rate, blastocyst development, embryo quality, 
chemical pregnancy, clinical pregnancy and ongoing pregnancy after ICSI were counted as the main 
outcomes. Results: Low FF AMH group shows significantly higher percentage of top-quality oocytes 
(67.1±24.3 vs. 49.6 ± 30.3 %, P =0.014), fertilization rate (83.9±20.9 vs. 72.4 ±21.4%, P =0.021), clinical 
pregnancy (57.57 vs. 16.67%, P >0.0001), and embryo implantation rates (57.7 vs. 16.7% , P =0.001) 
compared to high FF AMH group. FF AMH shares an inverse correlation with FF E2 (Pearson r = 
−0.409, p <0.001) and clinical pregnancy (Pearson r = −0.618, p<0.001). Threshold value of FF AMH for 
pregnancy is >1.75 ng/mg protein. Receiver operating characteristic analysis showed that the sensitivity 
of FF AMH at predicting CPR was 73.1 %; the specificity was 85.3 % and ROCAUC was 0.715 
(P < 0.0001). Conclusion: FF AMH is a plausible specific indicator of functional viability and quality of 
oocyte in IVF cycles.