Tags

Type your tag names separated by a space and hit enter

Antral follicle count, anti-mullerian hormone and inhibin B: predictors of ovarian response in assisted reproductive technology?
BJOG. 2005 Oct; 112(10):1384-90.BJOG

Abstract

OBJECTIVE

The objective of this study was to evaluate the relationship between anti-mullerian hormone (AMH), inhibin B and antral follicle count (AFC) with ovarian response.

DESIGN

Retrospective study.

SETTING

Fertility unit.

SAMPLE

AFC was recorded, and a serum sample obtained on day 3 from all patients undergoing in vitro fertilisation (IVF). Patients were given 300 IU/L recombinant follicle stimulating hormone (FSH; Gonal F). The following day blood samples were collected. METHODS Serum samples were assayed for FSH, AMH and inhibin B using commercial immunoassay kits and oestradiol using an in house assay.

MAIN OUTCOME MEASURES

Response to gonadotrophin stimulation and the number of eggs collected.

RESULTS

AFC was negatively correlated to age (r=-0.426, P < 0.001). Delta inhibin B (levels of inhibin B on day 4 minus day 3) had the best association to the number of eggs collected (r= 0.533, P < 0.001) followed by basal AMH (r= 0.51, P < 0.001) and AFC (r= 0.505, P < 0.001). The number of eggs fertilised was significantly associated with basal AMH (r= 0.592, P < 0.001) and inhibin B (r= 0.548, P < 0.001). AMH with a cutoff of 0.2 ng/mL had the best sensitivity (87%) and specificity (64%) in predicting poor response. A cumulative score using basal FSH, basal AMH, delta E2 (levels of oestradiol on day 4 minus day 3), delta inhibin B, AFC and age gives the best predictive statistics to identify poor responders with 87% sensitivity and 80% specificity and a positive likelihood ratio of 4.36.

CONCLUSION

Delta inhibin B had the best positive association with the number of eggs collected and basal AMH is the single best predictor of poor response. AFC has a significant association with the number of eggs collected and is predictive of clinical pregnancy. It is evident that a single parameter is of limited value in predicting ovarian response. However, we have demonstrated a cumulative score using all the above markers could be useful in predicting poor response.

Authors+Show Affiliations

Department of Obstetrics and Gynaecology, University College London, London, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16167941

Citation

Muttukrishna, S, et al. "Antral Follicle Count, Anti-mullerian Hormone and Inhibin B: Predictors of Ovarian Response in Assisted Reproductive Technology?" BJOG : an International Journal of Obstetrics and Gynaecology, vol. 112, no. 10, 2005, pp. 1384-90.
Muttukrishna S, McGarrigle H, Wakim R, et al. Antral follicle count, anti-mullerian hormone and inhibin B: predictors of ovarian response in assisted reproductive technology? BJOG. 2005;112(10):1384-90.
Muttukrishna, S., McGarrigle, H., Wakim, R., Khadum, I., Ranieri, D. M., & Serhal, P. (2005). Antral follicle count, anti-mullerian hormone and inhibin B: predictors of ovarian response in assisted reproductive technology? BJOG : an International Journal of Obstetrics and Gynaecology, 112(10), 1384-90.
Muttukrishna S, et al. Antral Follicle Count, Anti-mullerian Hormone and Inhibin B: Predictors of Ovarian Response in Assisted Reproductive Technology. BJOG. 2005;112(10):1384-90. PubMed PMID: 16167941.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antral follicle count, anti-mullerian hormone and inhibin B: predictors of ovarian response in assisted reproductive technology? AU - Muttukrishna,S, AU - McGarrigle,H, AU - Wakim,R, AU - Khadum,I, AU - Ranieri,D M, AU - Serhal,P, PY - 2005/9/20/pubmed PY - 2005/12/13/medline PY - 2005/9/20/entrez SP - 1384 EP - 90 JF - BJOG : an international journal of obstetrics and gynaecology JO - BJOG VL - 112 IS - 10 N2 - OBJECTIVE: The objective of this study was to evaluate the relationship between anti-mullerian hormone (AMH), inhibin B and antral follicle count (AFC) with ovarian response. DESIGN: Retrospective study. SETTING: Fertility unit. SAMPLE: AFC was recorded, and a serum sample obtained on day 3 from all patients undergoing in vitro fertilisation (IVF). Patients were given 300 IU/L recombinant follicle stimulating hormone (FSH; Gonal F). The following day blood samples were collected. METHODS Serum samples were assayed for FSH, AMH and inhibin B using commercial immunoassay kits and oestradiol using an in house assay. MAIN OUTCOME MEASURES: Response to gonadotrophin stimulation and the number of eggs collected. RESULTS: AFC was negatively correlated to age (r=-0.426, P < 0.001). Delta inhibin B (levels of inhibin B on day 4 minus day 3) had the best association to the number of eggs collected (r= 0.533, P < 0.001) followed by basal AMH (r= 0.51, P < 0.001) and AFC (r= 0.505, P < 0.001). The number of eggs fertilised was significantly associated with basal AMH (r= 0.592, P < 0.001) and inhibin B (r= 0.548, P < 0.001). AMH with a cutoff of 0.2 ng/mL had the best sensitivity (87%) and specificity (64%) in predicting poor response. A cumulative score using basal FSH, basal AMH, delta E2 (levels of oestradiol on day 4 minus day 3), delta inhibin B, AFC and age gives the best predictive statistics to identify poor responders with 87% sensitivity and 80% specificity and a positive likelihood ratio of 4.36. CONCLUSION: Delta inhibin B had the best positive association with the number of eggs collected and basal AMH is the single best predictor of poor response. AFC has a significant association with the number of eggs collected and is predictive of clinical pregnancy. It is evident that a single parameter is of limited value in predicting ovarian response. However, we have demonstrated a cumulative score using all the above markers could be useful in predicting poor response. SN - 1470-0328 UR - https://www.unboundmedicine.com/medline/citation/16167941/Antral_follicle_count_anti_mullerian_hormone_and_inhibin_B:_predictors_of_ovarian_response_in_assisted_reproductive_technology L2 - https://doi.org/10.1111/j.1471-0528.2005.00670.x DB - PRIME DP - Unbound Medicine ER -