Objective To evaluate predictive role of day-3 serum antiMüllerian hormone (AMH) levels and antral follicle count (AFC) in ovarian hyperstimulation syndrome (OHSS) in patients undergoing IVF/ICSI cycles. Materials and methods Forty-one women with moderate/ severe OHSS and 41 age matched women without OHSS were compared to evaluate the predictive value of certain risk factors for OHSS. AFC, and E 2 , FSH, LH, AMH, inhibin-B levels measured on day 3 of the menstrual cycle before controlled ovarian hyperstimulation. Results Mean FSH was significantly lower (p<0.0001); and mean LH, AFC and AMH were significantly higher in women with OHSS compared to women without OHSS (p=0.049, p<0.0001 and p<0.0001, respectively). There was no significant difference in inhibin B (p=0.112) and estradiol (p=0.706) between the groups. The ROC area under curve (AUC) for AMH presented the largest AUC among the listed risk factors. AMH (AUC=0.87) and AFC (AUC=0.74) had moderate accuracy for predicting OHSS while Inhibin B (AUC=0.58) and LH (AUC= 0.61) had low accuracy. The cut-off value for AMH 3.3 ng/mL provided the highest sensitivity (90%) and specificity (71%) for predicting OHSS. It's positive (PPV) and negative predictive values (NPV) were 61% and 94%, respectively. The cut-off value for AFC was 8 with 78% sensitivity, 65% specificity, 52% PPV and 86% NPV. Conclusion Measurement of basal serum AMH and AFC can be used to determine the women with high risk for OHSS.

Different AMH levels may predict the quality of oocytes, presence of postmaturity and nucleoli Z score, early cleavage and ICSI outcomes.

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Low follicular fluid homocysteine level is associated with a better chance of clinical pregnancy.

Purpose To evaluate the clinical value of day 3 serum anti-Müllerian hormone (AMH) compared with day 3 serum follicle-stimulating hormone (FSH) and human chorionic gonadotropin (hCG) day estradiol (E2) levels and antral follicle count (AFC) in the prediction of poor ovarian response in controlled ovarian hyperstimulation (COH). Methods AMH, FSH and AFC on day 3 as well as hCG day E2 levels were determined in 164 subjects. Receiver operating curve analyses and area under curves (AUC) of the study parameters were performed. Predictive values of the levels of day 3 AMH, FSH, AFC, and hCG day E2 as clinical parameters of ovarian response to COH were studied. Results Thirty-eight women were defined as poor responders. The day 3 AMH and hCG day E2 levels and AFC of normal responders were significantly higher than those of the poor responders. In predicting poor response, the AUC of day 3 AMH level was significantly higher than that of day 3 FSH level but was similar to the hCG day E2 level. Day 3 AMH, FSH and hCG day E2 levels and AFC were found to predict a poor response. Day 3 AMH and hCG day E2 levels were more predictive compared with day 3 FSH level and AFC. The cut-off level of AMH was B2 with a sensitivity of 78.9% and a specificity of 73.8%. Conclusion Day 3 AMH has the ability to predict a poor response to COH and it is more predictive than day 3 FSH and AFC.