Anti-mullerian hormone and antral follicle count as predictors of ovarian response in assisted reproduction

Abstract

OBJECTIVE:The objective of this study was to test the hypothesis that AMH and antral follicle count (AFC) are good predictors of ovarian response to controlled ovarian stimulation and to compare them.MATERIALS AND METHODS:This observational cross-sectional study included 56 subjects aged between 25 and 42 years who were enrolled between 1st January and 31st December 2010 for their first intracytoplasmic sperm injection (ICSI) program. Baseline hormone profiles including serum levels of Estradiol (E2), Follicle-stimulating hormone (FSH), Luteinizing hormone (LH), and Anti-mullerian Hormone (AMH) were determined on day 3 of the previous cycle. The antral follicle count measurements were performed on days 3-5 of the same menstrual cycle. Antral follicles within the bilateral ovaries between 2-6 mm were recorded. The subjects were treated with long protocol for ovarian stimulation. Ovulation was induced with 10,000 IU of human chorionic gonadotropin (hCG) when at least 3 follicles attained the size of more than 17 mm. Transvaginal oocyte retrieval was performed under ultrasound guidance 36 hours after hCG administration. An oocyte count less than 4 and absence of follicular growth with controlled ovarian hyper stimulation was considered as poor ovarian response. Oocyte count of 4 or more was considered as normal ovarian response.RESULTS:Statistical analysis was performed using SPSS software trail version 16.0. Subjects were divided into 2 groups, depending on the ovarian response. The mean oocyte counts were 12.27 ± 6.06 and 2.22 ± 1.24 in normal and poor responders, respectively, (P = 001). Multiple regression analysis revealed AMH and antral follicle count as predictors of ovarian response (β coefficient ± SE for AMH was 1.618 ± 0.602 (P = 0.01) and for AFC, it was, 0.528 ± 0.175 (P = 0.004). AFC was found to be a better predictor of ovarian response compared to AMH in controlled ovarian hyper stimulation.CONCLUSION:The observations made in this study revealed that both AMH and AFC are good predictors of ovarian response; AFC being a better predictor compared to AMH.

Assessing ovarian response: antral follicle count versus anti-Müllerian hormone

“…For several important IVF outcomes, AFC has been associated with good predictive value, showing a linear relationship with the number of retrieved oocytes (Chang et al, 1998a(Chang et al, , 1998bHimabindu et al, 2013;Hsu et al, 2011;Tsakos et al, 2014) and correlation with measures of ovarian response to gonadotrophins, including cycle cancellations as a result of poor response (Frattarelli et al, 2000;Tomas et al, 1997). Reports examining the correlation with clinical pregnancy rate and live birth rate, however, are more variable (Chang et al, 1998a(Chang et al, , 1998bHsu et al, 2011;Jayaprakasan et al, 2012;Lukaszuk et al, 2014), and AFC has not been shown to be predictive of embryo quality (Chang et al, 1998a(Chang et al, , 1998bHsu et al, 2011;Jayaprakasan et al, 2012).…”

Pregnancy Outcomes in Infertile Women with Polycystic Ovaries following Intracellular Sperm Injection

“…This might be due to the fact that patients with PCOS or PCOM have high antral follicle count (AFC), and by inclusion criteria, patients with AFC >12 follicles/ovary were classified as PCOM or PCOS patients. Interestingly, basal follicle number had a positive linear correlation with recovered oocytes and basal and peak E2 and a negative linear correlation with both number of ampules of administered gonadotropin and days of stimulation [16][17][18]. This means in patients with normal ovaries, a set of follicles, from a follicular pool of less than 12 follicles/ovary, will develop and ovulate during the ovarian hyperstimulation.…”

Niveles séricos de hormona antimulleriana como predictor de baja respuesta en mujeres sometidas a ciclos de fecundación in vitro

“…La AMH es mejor que el RFA en algunos estudios (Arce et al, 2013;Fiçicioǧlu et al, 2006;Mutlu et al, 2013), sin embargo otros reportan resultados similares de los dos marcadores (Jayaprakasan et al, 2010;Muttukrishna et al, 2005) y en 3 el RFA fue superior a AMH (Himabindu et al, 2013;Kwee et al, 2008;Mutlu et al, 2013). Las discrepancias entre los diferentes estudios pueden ser atribuidas a la heterogeneidad de la población de estudio, así como a las diferencias en la definición de la pobre respuesta a la estimulación ovárica.…”