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Archives of Gynecology and Obstetrics
Published in: Archives of Gynecology and Obstetrics 6/2011

01-06-2011 | Reproductive Medicine

Anti-Mullerian hormone is a better marker than inhibin B, follicle stimulating hormone, estradiol or antral follicle count in predicting the outcome of in vitro fertilization

Authors: Cigdem Kunt, Gulnur Ozaksit, Raziye Keskin Kurt, Ayse Nur Cakir Gungor, Mine Kanat-Pektas, Sevtap Kilic, Arzu Dede

Published in: Archives of Gynecology and Obstetrics | Issue 6/2011

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Abstract

Objective

The present study aims to compare anti-Mullerian hormone (AMH) with other ovarian reserve markers and to find a cut-off value of AMH for predicting ovarian response towards controlled ovarian hyperstimulation in an in vitro fertilization (IVF) program.

Materials and methods

A prospective analysis was performed in 180 patients undergoing their first IVF trial, which is being conducted at a department of assisted reproduction in a tertiary medical center. The main outcome measures were determined as age and antral follicle count as well as the serum concentrations of follicle stimulating hormone, luteinizing hormone (LH), estradiol (E2), inhibin B and AMH. The predictive power of the aforementioned measures in specifying ovarian response was determined by means of discriminate analyses.

Results

As expected, day 3 LH levels were significantly high in the poor responder group. The poor responders had significantly lower antral follicle counts, retrieved oocyte number, and mature oocyte counts as well as day 3 AMH levels (5.8 ± 2.32 vs. 1.8 ± 0.80 ng/ml).
There was a positive correlation with antral follicle count, basal AMH, E2 and follicle count on the day of HCG administration and negative correlation with age. The AMH level was addressed as the only significant factor in determination of mature oocyte number. A cut-off point for serum AMH concentration indicating the value of 2.97 ng/ml was found to predict the poor ovarian response with a sensitivity of 100.0% and a specificity of 89.6%. However, the same cut-off point was not as predictive for the non-conception circumstance.

Conclusion

The present study concludes that AMH is a promising biochemical marker for the prediction of ovarian response and that a cut-off point indicating the value of 2.97 ng/ml can be adopted for this prediction.
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Metadata
Title
Anti-Mullerian hormone is a better marker than inhibin B, follicle stimulating hormone, estradiol or antral follicle count in predicting the outcome of in vitro fertilization
Authors
Cigdem Kunt
Gulnur Ozaksit
Raziye Keskin Kurt
Ayse Nur Cakir Gungor
Mine Kanat-Pektas
Sevtap Kilic
Arzu Dede
Publication date
01-06-2011
Publisher
Springer-Verlag
Published in
Archives of Gynecology and Obstetrics / Issue 6/2011
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-011-1889-7

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