Day 5 inhibin B levels in a treatment cycle are predictive of IVF outcome.
BACKGROUND
Day 5 serum inhibin B during IVF treatment has been investigated as a predictor of outcome.


METHODS
A total of 54 women (< or = 39 years, normal menses and endocrine profiles) were treated with urinary gonadotrophins or recombinant FSH following pituitary down-regulation. Serum day 3 FSH in a preceding cycle was <8.5 IU/l. Plasma inhibin B, inhibin A and estradiol were determined after 4 days of gonadotrophin administration (day 5).


RESULTS
Day 5 inhibin B was the most highly correlated with the number of mature follicles (>14 mm), oocytes retrieved and fertilized. Receiver operating characteristic analysis gave high accuracy for day 5 inhibin B in predicting ovarian response and indicated that a threshold of 400 pg/ml may be helpful in the decision as to whether to continue treatment. Women with <400 pg/ml (n = 16) had lower numbers of follicles, mature follicles, oocytes retrieved, fertilized and cleaved compared with those >400 pg/ml (n = 36) and this threshold gave a positive likelihood ratio of 30, 92.9% sensitivity, 95.0% specificity and 86.7% positive predictive value to detect poor ovarian response. Day 5 inhibin B was the best predictor of pregnancy (no live births and four cycles cancelled, low inhibin group; nine live births and no cancelled cycles, high inhibin group).


CONCLUSIONS
Normogonadotrophic, normogonadal women with day 5 inhibin B <400 pg/ml in down-regulated cycles have a poor response to ovarian stimulation and are less likely to conceive compared with women with higher day 5 inhibin B.
Fawzy
M
M
Human Assisted Reproduction Unit, Rotunda Hospital, Dublin 1, Ireland.
Lambert
A
A
Harrison
R F
RF
Knight
P G
PG
Groome
N
N
Hennelly
B
B
Robertson
W R
WR
D000328:Adult; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007231:Infant, Newborn; D007265:Inhibins / Q000097:blood*; D010062:Ovulation Induction; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012372:ROC Curve; D016896:Treatment Outcome
C422364:inhibin B; D007265:Inhibins