Skip to main content
Top
Published in: Archives of Gynecology and Obstetrics 6/2014

01-12-2014 | Gynecologic Endocrinology and Reproductive Medicine

Predictive value of anti-müllerian hormone, follicle-stimulating hormone and antral follicle count on the outcome of ovarian stimulation in women following GnRH-antagonist protocol for IVF/ET

Authors: E. Tsakos, A. Tolikas, Angelos Daniilidis, B. Asimakopoulos

Published in: Archives of Gynecology and Obstetrics | Issue 6/2014

Login to get access

Abstract

Aim

To compare the efficacy of three methods: the levels of anti-müllerian hormone (AMH), the levels of follicle stimulating hormone (FSH) and the antral follicle count (AFC), for the prediction of the number of retrieved mature oocytes and the number of generated embryos by intracytoplasmic sperm injection (ICSI) in women stimulated with a GnRH-antagonist protocol.

Materials and methods

105 women were enrolled in the study. At the day 2 of a preceding cycle, AFC was performed and FSH and AMH were measured in serum by immunoenzymatic assays. All women were stimulated with a GnRH-antagonist protocol and ovulation was induced with human chorionic gonadotropin. ICSI was performed in all retrieved mature oocytes. Embryo transfers were performed at days 2–3. According to the oocytes retrieved, patients were categorized as poor (<4), normal (4–12) or high responders (>12).

Results

AFC and the levels of baseline FSH and AMH were significantly different among poor, normal and high responders. The number of oocytes as well as the number of embryos was negatively correlated with baseline FSH and positively correlated with baseline AMH and AFC, whereas AFC showed the strongest correlation. Stepwise regression analysis indicated AFC and baseline AMH as the most significant parameters for the prediction of the number of oocytes; for the prediction of the number of embryos, the most significant parameter was AFC.

Conclusions

AFC, baseline AMH and baseline FSH are good predictors for the outcome of ovarian stimulation in GnRH-antagonist cycles. However, AFC appears to have the best predictive value.
Literature
1.
go back to reference Kolibianakis EM, Griesinger G, Tarlatzis BC (2012) GnRH-antagonists in ovarian stimulation for IVF. In: Gardner DK, Weissman A, howles CM, Shoham Z (eds) Textbook for Assisted Reproductive Techniques, 4th edn, vol 2, clinical perspectives. Informa healthcare, pp 124–131 Kolibianakis EM, Griesinger G, Tarlatzis BC (2012) GnRH-antagonists in ovarian stimulation for IVF. In: Gardner DK, Weissman A, howles CM, Shoham Z (eds) Textbook for Assisted Reproductive Techniques, 4th edn, vol 2, clinical perspectives. Informa healthcare, pp 124–131
2.
go back to reference Johnson J, Canning J, Kaneko T, Pu JK, Tilly JL (2004) Germline stem cells and follicular renewal in the postnatal mammalian ovary. Nature 428(6979):145–150PubMedCrossRef Johnson J, Canning J, Kaneko T, Pu JK, Tilly JL (2004) Germline stem cells and follicular renewal in the postnatal mammalian ovary. Nature 428(6979):145–150PubMedCrossRef
3.
go back to reference Fauser BC, Diedrich K, Devroey P, Evian Annual Reproduction Workshop Group 2007 (2008) Predictors of ovarian response: progress towards individualized treatment in ovulation induction and ovarian stimulation. Hum Reprod Update 14(1):1–14PubMedCrossRef Fauser BC, Diedrich K, Devroey P, Evian Annual Reproduction Workshop Group 2007 (2008) Predictors of ovarian response: progress towards individualized treatment in ovulation induction and ovarian stimulation. Hum Reprod Update 14(1):1–14PubMedCrossRef
4.
go back to reference Tsepelidis S, Devreker F, Demeestere I, Flahaut A, Gervy Ch, Englert Y (2007) Stable serum levels of anti-Müllerian hormone during the menstrual cycle: a prospective study in normo-ovulatory women. Hum Reprod 22:1837–1840PubMedCrossRef Tsepelidis S, Devreker F, Demeestere I, Flahaut A, Gervy Ch, Englert Y (2007) Stable serum levels of anti-Müllerian hormone during the menstrual cycle: a prospective study in normo-ovulatory women. Hum Reprod 22:1837–1840PubMedCrossRef
5.
go back to reference Baczkowski T, Kurzawa R, Glabowski W (2004) Methods of embryo scoring in in vitro fertilization. Reprod Biol 4(1):5–22PubMed Baczkowski T, Kurzawa R, Glabowski W (2004) Methods of embryo scoring in in vitro fertilization. Reprod Biol 4(1):5–22PubMed
6.
go back to reference Penarrubia J, Fábeques F, Manau D, Creus M, Casals G, Casamitjana R et al (2005) Basal and stimulation day 5 anti-mullerian hormone serum concentrations as predictors of ovarian response and pregnancy in assisted reproductive technology cycles stimulated with gonadotropin-releasing hormone agonist—gonadotropin treatment. Hum Reprod 20(4):915–922PubMedCrossRef Penarrubia J, Fábeques F, Manau D, Creus M, Casals G, Casamitjana R et al (2005) Basal and stimulation day 5 anti-mullerian hormone serum concentrations as predictors of ovarian response and pregnancy in assisted reproductive technology cycles stimulated with gonadotropin-releasing hormone agonist—gonadotropin treatment. Hum Reprod 20(4):915–922PubMedCrossRef
7.
go back to reference Van Rooij IA, Broekmans FJ, te Velde ER, Fauser BC, Bancsi LF, Jong FH et al (2002) Serum anti-mullerian hormone levels: a novel measure of ovarian reserve. Hum Reprod 17:3065–3071PubMedCrossRef Van Rooij IA, Broekmans FJ, te Velde ER, Fauser BC, Bancsi LF, Jong FH et al (2002) Serum anti-mullerian hormone levels: a novel measure of ovarian reserve. Hum Reprod 17:3065–3071PubMedCrossRef
8.
go back to reference Muttukrishna S, McGarrigle H, Wakim R, Khadum I, Ranieri DM, Serhal P (2005) Antral follicle count, anti-mullerian hormone and inhibin B: predictors of ovarian response in assisted reproductive technology? BJOG 112:1384–1390PubMedCrossRef Muttukrishna S, McGarrigle H, Wakim R, Khadum I, Ranieri DM, Serhal P (2005) Antral follicle count, anti-mullerian hormone and inhibin B: predictors of ovarian response in assisted reproductive technology? BJOG 112:1384–1390PubMedCrossRef
9.
go back to reference Elgindy EA, El-Haieg DO, El-Sebaey A (2008) Anti-mullerian hormone: correlation of early follicular, ovulatory and midluteal levels with ovarian response and cycle outcome in intracytoplasmic sperm injection patients. Fertil Steril 89:1670–1676PubMedCrossRef Elgindy EA, El-Haieg DO, El-Sebaey A (2008) Anti-mullerian hormone: correlation of early follicular, ovulatory and midluteal levels with ovarian response and cycle outcome in intracytoplasmic sperm injection patients. Fertil Steril 89:1670–1676PubMedCrossRef
10.
go back to reference Lekamge DN, Barry M, Kolo M, Lane M, Gilchrist RB, Tremellen KP (2007) Anti-mullerian hormone as a predictor of IVF outcome. Reprod Biomed Online 14:602–610PubMedCrossRef Lekamge DN, Barry M, Kolo M, Lane M, Gilchrist RB, Tremellen KP (2007) Anti-mullerian hormone as a predictor of IVF outcome. Reprod Biomed Online 14:602–610PubMedCrossRef
11.
go back to reference Broer SL, Mol BW, Hendriks D, Broekmans FJ (2009) The role of antimullerian hormone in prediction of outcome after IVF: comparison with the antral follicle count. Fertil Steril 91(3):705–714PubMedCrossRef Broer SL, Mol BW, Hendriks D, Broekmans FJ (2009) The role of antimullerian hormone in prediction of outcome after IVF: comparison with the antral follicle count. Fertil Steril 91(3):705–714PubMedCrossRef
12.
go back to reference Jayaprakasan K, Campbell B, Hopkisson J, Johnson I, Raine-Fenning N (2010) A prospective, comparative analysis of anti-Mullerian hormone, inhibin-B, and three-dimensional ultrasound determinants of ovarian reserve in the prediction of poor response to controlled ovarian stimulation. Fertil Steril 93(3):855–864PubMedCrossRef Jayaprakasan K, Campbell B, Hopkisson J, Johnson I, Raine-Fenning N (2010) A prospective, comparative analysis of anti-Mullerian hormone, inhibin-B, and three-dimensional ultrasound determinants of ovarian reserve in the prediction of poor response to controlled ovarian stimulation. Fertil Steril 93(3):855–864PubMedCrossRef
13.
go back to reference Broer SL, Dolleman M, Opmeer BC, Fauser BC, Mol BW, Broekmans FJ (2011) AMH and AFC as predictors of excessive response in controlled ovarian hyperstimulation: a meta-analysis. Hum Reprod Update 17(1):46–54PubMedCrossRef Broer SL, Dolleman M, Opmeer BC, Fauser BC, Mol BW, Broekmans FJ (2011) AMH and AFC as predictors of excessive response in controlled ovarian hyperstimulation: a meta-analysis. Hum Reprod Update 17(1):46–54PubMedCrossRef
14.
go back to reference Broer SL, van Disseldorp J, Broeze KA, Dolleman M, Opmeer BC, Bossuyt P et al (2013) Added value of ovarian reserve testing on patient characteristics in the prediction of ovarian response and ongoing pregnancy: an individual patient data approach. Hum Reprod Update 19(1):26–36PubMedCrossRef Broer SL, van Disseldorp J, Broeze KA, Dolleman M, Opmeer BC, Bossuyt P et al (2013) Added value of ovarian reserve testing on patient characteristics in the prediction of ovarian response and ongoing pregnancy: an individual patient data approach. Hum Reprod Update 19(1):26–36PubMedCrossRef
15.
go back to reference Eldar-Geva T, Ben-Chetrit A, Spitz IM, Rabinowitz R, Markowitz E, Mimoni T et al (2005) Dynamic assays of inhibin B, anti-mullerian hormone and estradiol following FSH stimulation and ovarian ultrasonography as predictors of IVF outcome. Hum Reprod 20:3178–3183PubMedCrossRef Eldar-Geva T, Ben-Chetrit A, Spitz IM, Rabinowitz R, Markowitz E, Mimoni T et al (2005) Dynamic assays of inhibin B, anti-mullerian hormone and estradiol following FSH stimulation and ovarian ultrasonography as predictors of IVF outcome. Hum Reprod 20:3178–3183PubMedCrossRef
16.
go back to reference Kwee J, Schats R, McDonnell J, Themmen A, de Jong F, Lambalk C (2008) Evaluation of anti-müllerian hormone as a test for the prediction of ovarian reserve. Fertil Steril 90:737–743PubMedCrossRef Kwee J, Schats R, McDonnell J, Themmen A, de Jong F, Lambalk C (2008) Evaluation of anti-müllerian hormone as a test for the prediction of ovarian reserve. Fertil Steril 90:737–743PubMedCrossRef
17.
go back to reference Fanchin R, Mendez Lozano DH, Frydman N, Gougeon A, di Clemente N, Frydman R et al (2007) Anti-müllerian hormone concentrations in the follicular fluid of the preovulatory follicle are predictive of the implantation potential of the ensuing embryo obtained by in vitro fertilization. J Clin Endocrinol Metab 92(5):1796–1802PubMedCrossRef Fanchin R, Mendez Lozano DH, Frydman N, Gougeon A, di Clemente N, Frydman R et al (2007) Anti-müllerian hormone concentrations in the follicular fluid of the preovulatory follicle are predictive of the implantation potential of the ensuing embryo obtained by in vitro fertilization. J Clin Endocrinol Metab 92(5):1796–1802PubMedCrossRef
Metadata
Title
Predictive value of anti-müllerian hormone, follicle-stimulating hormone and antral follicle count on the outcome of ovarian stimulation in women following GnRH-antagonist protocol for IVF/ET
Authors
E. Tsakos
A. Tolikas
Angelos Daniilidis
B. Asimakopoulos
Publication date
01-12-2014
Publisher
Springer Berlin Heidelberg
Published in
Archives of Gynecology and Obstetrics / Issue 6/2014
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-014-3332-3

Other articles of this Issue 6/2014

Archives of Gynecology and Obstetrics 6/2014 Go to the issue