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Published in: Journal of Assisted Reproduction and Genetics 8/2012

01-08-2012 | ASSISTED REPRODUCTION TECHNOLOGIES

Random anti-Müllerian hormone predicts ovarian response in women with high baseline follicle-stimulating hormone levels

Anti-Müllerian hormone in poor responders in assisted reproductive treatment

Authors: Handan Celik, Devran Bıldırcın, Davut Güven, Mehmet B. Cetinkaya, Tayfun Alper, A. Sertaç Batuoğlu

Published in: Journal of Assisted Reproduction and Genetics | Issue 8/2012

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Abstract

Objective

To evaluate the predictive value of random serum anti-Müllerian hormone (AMH) in the assessment of ovarian response in patients with diminished ovarian reserve (DOR; diagnosed after the observation of elevated baseline levels of early follicular follicle-stimulating hormone [FSH]) who were undergoing intracytoplasmic sperm injection-embryo transfer (ICSI-ET) and to compare the random serum AMH and baseline FSH levels in these patients for the prediction of poor ovarian response.

Design

Retrospective study.

Setting

University hospital.

Patients

One hundred and thirty-nine patients who were undergoing ICSI-ET cycles with early follicular FSH level >9 IU/mL.

Intervention(s)

None.

Main Outcome Measure(s)

Poor ovarian response in ICSI-ET cycles.

Results

For the identification of women at risk of cycle cancellation, an AMH cut-off level ≤1.2 ng/mL had 97.3 % sensitivity, 31.3 % specificity, 33.9 % positive predictive value, and 96.9 % negative predictive value in the women with high baseline FSH levels. An AMH cut-off level ≥1 ng/mL had a sensitivity of 58.7 % and specificity of 95.1 % for prediction of retrieval of 4 or more oocytes. By using a serum AMH cutoff level of 1.5 ng/mL, the ongoing pregnancies were predicted with 83.3 % sensitivity and 82.5 % specificity and yielded a positive predictive value of 31.2 % and a negative predictive value 98.1 %.

Conclusion

Measurement of random serum AMH level is a useful tool in the prediction of ovarian response in patients with high serum early follicular FSH levels.
Literature
1.
go back to reference Arslan M, Bocca S, Mirkin S, Barroso G, Stadtmauer L, Oehninger S. Controlled ovarian hyperstimulation protocols for in vitro fertilization: two decades of experience after the birth of Elizabeth Carr. Fertil Steril. 2005;84:555–69.PubMedCrossRef Arslan M, Bocca S, Mirkin S, Barroso G, Stadtmauer L, Oehninger S. Controlled ovarian hyperstimulation protocols for in vitro fertilization: two decades of experience after the birth of Elizabeth Carr. Fertil Steril. 2005;84:555–69.PubMedCrossRef
2.
go back to reference Scott RT, Hofmann GE. Prognostic assessment of ovarian reserve. Fertil Steril. 1995;63:1–11.PubMed Scott RT, Hofmann GE. Prognostic assessment of ovarian reserve. Fertil Steril. 1995;63:1–11.PubMed
3.
go back to reference Bancsi LF, Broekmans FJ, Eijkemans MJ, de Jong FH, Habbema JD, te Velde ER. Predictors of poor ovarian response in in vitro fertilization: a prospective study comparing basal markers of ovarian reserve. Fertil Steril. 2002;77:328–36.PubMedCrossRef Bancsi LF, Broekmans FJ, Eijkemans MJ, de Jong FH, Habbema JD, te Velde ER. Predictors of poor ovarian response in in vitro fertilization: a prospective study comparing basal markers of ovarian reserve. Fertil Steril. 2002;77:328–36.PubMedCrossRef
4.
go back to reference Broekmans FJ, Kwee J, Hendriks DJ, Mol BW, Lambalk CB. A systematic review of tests predicting ovarian reserve and IVF outcome. Hum Reprod Update. 2006;12:685–718.PubMedCrossRef Broekmans FJ, Kwee J, Hendriks DJ, Mol BW, Lambalk CB. A systematic review of tests predicting ovarian reserve and IVF outcome. Hum Reprod Update. 2006;12:685–718.PubMedCrossRef
5.
go back to reference Fıçıcıoğlu C, Kutlu T, Baglam E, Bakacak Z. Early follicular antimüllerian hormone as an indicator of ovarian reserve. Fertil Steril. 2006;85:592–6.PubMedCrossRef Fıçıcıoğlu C, Kutlu T, Baglam E, Bakacak Z. Early follicular antimüllerian hormone as an indicator of ovarian reserve. Fertil Steril. 2006;85:592–6.PubMedCrossRef
6.
go back to reference Lee MM, Donahoe PK, Hasegawa T, Silverman B, Crist GB, Best S, et al. Mullerian inhibiting substance in humans: normal levels from infancy to adulthood. J Clin Endocrinol Metab. 1996;81:571–76.PubMedCrossRef Lee MM, Donahoe PK, Hasegawa T, Silverman B, Crist GB, Best S, et al. Mullerian inhibiting substance in humans: normal levels from infancy to adulthood. J Clin Endocrinol Metab. 1996;81:571–76.PubMedCrossRef
7.
go back to reference Sahmay S, Cetin M, Ocal P, Kaleli S, Senol H, Birol F, Irez T. Serum anti-müllerian hormone level as a predictor of poor ovarian response in in vitro fertilization patient. Reprod Med Biol. 2011;10:9–14.CrossRef Sahmay S, Cetin M, Ocal P, Kaleli S, Senol H, Birol F, Irez T. Serum anti-müllerian hormone level as a predictor of poor ovarian response in in vitro fertilization patient. Reprod Med Biol. 2011;10:9–14.CrossRef
8.
go back to reference Van Rooij IA, Broekmans FJ, te Velde ER, Fauser BC, Bancsi LF, Jong FH, et al. Serum antimullerian hormone levels: a novel measure of ovarian reserve. Hum Reprod. 2002;17:3065–71.PubMedCrossRef Van Rooij IA, Broekmans FJ, te Velde ER, Fauser BC, Bancsi LF, Jong FH, et al. Serum antimullerian hormone levels: a novel measure of ovarian reserve. Hum Reprod. 2002;17:3065–71.PubMedCrossRef
9.
go back to reference Gruijters MJ, Visser JA, Durlinger AL, Themmen AP. Antimullerian hormone and its role in ovarian function. Mol Cell Endocrinol. 2003;211:85–90.PubMedCrossRef Gruijters MJ, Visser JA, Durlinger AL, Themmen AP. Antimullerian hormone and its role in ovarian function. Mol Cell Endocrinol. 2003;211:85–90.PubMedCrossRef
10.
go back to reference La Marca A, Sighinolfi G, Radi D, Argento C, Baraldi E, Artenisio CA, et al. Anti-Müllerian hormone (AMH) as a predictive marker in assisted reproductive technology (ART). Hum Reprod Update. 2010;16:113–30.PubMedCrossRef La Marca A, Sighinolfi G, Radi D, Argento C, Baraldi E, Artenisio CA, et al. Anti-Müllerian hormone (AMH) as a predictive marker in assisted reproductive technology (ART). Hum Reprod Update. 2010;16:113–30.PubMedCrossRef
11.
go back to reference Broer SL, Mol BWJ, Hendriks D, Broekmans FJM. The role of antimullerian hormone in predicting outcome after IVF: comparison with antral follicle count. Fertil Steril. 2009;91:705–14.PubMedCrossRef Broer SL, Mol BWJ, Hendriks D, Broekmans FJM. The role of antimullerian hormone in predicting outcome after IVF: comparison with antral follicle count. Fertil Steril. 2009;91:705–14.PubMedCrossRef
12.
go back to reference La Marca A, Volpe A. Anti-Mullerian hormone (AMH) in female reproduction: is measurement of circulating AMH a useful tool? Clin Endocrinol. 2006;64:603–10.CrossRef La Marca A, Volpe A. Anti-Mullerian hormone (AMH) in female reproduction: is measurement of circulating AMH a useful tool? Clin Endocrinol. 2006;64:603–10.CrossRef
13.
go back to reference Hehenkamp WJ, Looman CW, Themmen AP, de Jong FH, Te Velde ER, Broekmans FJ. Anti-Mullerian hormone levels in the spontaneous menstrual cycle do not show substantial fluctuation. J Clin Endocrinol Metab. 2006;91:4057–63.PubMedCrossRef Hehenkamp WJ, Looman CW, Themmen AP, de Jong FH, Te Velde ER, Broekmans FJ. Anti-Mullerian hormone levels in the spontaneous menstrual cycle do not show substantial fluctuation. J Clin Endocrinol Metab. 2006;91:4057–63.PubMedCrossRef
14.
go back to reference Garcia JE, Jones GS, Acosta AA, Wright G. HMG/hCGfollicular maturation for oocytes aspiration: phase II, 1981. Fertil Steril. 1983;39:174–9.PubMed Garcia JE, Jones GS, Acosta AA, Wright G. HMG/hCGfollicular maturation for oocytes aspiration: phase II, 1981. Fertil Steril. 1983;39:174–9.PubMed
15.
go back to reference Raga F, Bonilla-Musoles F, Casan EM, Bonilla F. Recombinant follicle stimulating hormone stimulation in poor responders with normal basal concentrations of follicle stimulating hormone and oestradiol: improved reproductive outcome. Hum Reprod. 1999;14:1431–4.PubMedCrossRef Raga F, Bonilla-Musoles F, Casan EM, Bonilla F. Recombinant follicle stimulating hormone stimulation in poor responders with normal basal concentrations of follicle stimulating hormone and oestradiol: improved reproductive outcome. Hum Reprod. 1999;14:1431–4.PubMedCrossRef
16.
go back to reference Land J, Yarmolinskaya M, Dumoulin J, Evers J. High-dose human menopausal gonadotropin stimulation in poor responders does not improve in vitro fertilization outcome. Fertil Steril. 1996;65:961–5.PubMed Land J, Yarmolinskaya M, Dumoulin J, Evers J. High-dose human menopausal gonadotropin stimulation in poor responders does not improve in vitro fertilization outcome. Fertil Steril. 1996;65:961–5.PubMed
17.
go back to reference Karande V, Gleicher N. A rational approach to the management of low responders in IVF. Hum Reprod. 1999;14:1744–9.PubMedCrossRef Karande V, Gleicher N. A rational approach to the management of low responders in IVF. Hum Reprod. 1999;14:1744–9.PubMedCrossRef
18.
go back to reference Ferraretti AP, La Marca A, Fauser BJCM, Tarlatzis B, Nargund G, Gianaroli L. ESHRE consensus on the definition of ‘poor response’ to ovarian stimulation for in vitro fertilization: the Bologna criteria. Hum Reprod. 2011;26:1616–24.PubMedCrossRef Ferraretti AP, La Marca A, Fauser BJCM, Tarlatzis B, Nargund G, Gianaroli L. ESHRE consensus on the definition of ‘poor response’ to ovarian stimulation for in vitro fertilization: the Bologna criteria. Hum Reprod. 2011;26:1616–24.PubMedCrossRef
19.
go back to reference Buyuk E, Seifer DB, Younger J, Grazi RV, Lieman HM. Random anti-Müllerian hormone (AMH) is a predictor of ovarian response in women with elevated baseline early follicular follicle-stimulating hormone levels. Fertil Steril. 2011;95:2369–72.PubMedCrossRef Buyuk E, Seifer DB, Younger J, Grazi RV, Lieman HM. Random anti-Müllerian hormone (AMH) is a predictor of ovarian response in women with elevated baseline early follicular follicle-stimulating hormone levels. Fertil Steril. 2011;95:2369–72.PubMedCrossRef
21.
go back to reference Gleicher N, Weghofer A, Barad DH. Anti-Mullerian hormone (AMH) defines, independent of age, low versus good live-birth chances in women with severely diminished ovarian reserve. Fertil Steril. 2010;94:2824–7.PubMedCrossRef Gleicher N, Weghofer A, Barad DH. Anti-Mullerian hormone (AMH) defines, independent of age, low versus good live-birth chances in women with severely diminished ovarian reserve. Fertil Steril. 2010;94:2824–7.PubMedCrossRef
22.
go back to reference Barad DH, Weghofer A, Gleicher N. Comparing anti-Mullerian hormone (AMH) and follicle- stimulating hormone (FSH) as predictors of ovarian function. Fertil Steril. 2009;91:1553–5.PubMedCrossRef Barad DH, Weghofer A, Gleicher N. Comparing anti-Mullerian hormone (AMH) and follicle- stimulating hormone (FSH) as predictors of ovarian function. Fertil Steril. 2009;91:1553–5.PubMedCrossRef
Metadata
Title
Random anti-Müllerian hormone predicts ovarian response in women with high baseline follicle-stimulating hormone levels
Anti-Müllerian hormone in poor responders in assisted reproductive treatment
Authors
Handan Celik
Devran Bıldırcın
Davut Güven
Mehmet B. Cetinkaya
Tayfun Alper
A. Sertaç Batuoğlu
Publication date
01-08-2012
Publisher
Springer US
Published in
Journal of Assisted Reproduction and Genetics / Issue 8/2012
Print ISSN: 1058-0468
Electronic ISSN: 1573-7330
DOI
https://doi.org/10.1007/s10815-012-9794-y

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