Dynamic assays of inhibin B, anti-Mullerian hormone and estradiol following FSH stimulation and ovarian ultrasonography as predictors of IVF outcome.
BACKGROUND
We evaluated basal and dynamic hormonal markers [(FSH, inhibin B, estradiol and anti-Mullerian hormone (AMH)] during the follicular phase and luteal phase of the menstrual cycle and ultrasonic ovarian morphology as predictors of IVF outcome.


METHODS
Fifty-six women, aged <38 years, with normal day 3 FSH levels were included prospectively. Serum estradiol, inhibin B and AMH were measured before and 24 h after administration of 300 IU of recombinant FSH on cycle day 3-4 and during the luteal phase. Ovarian volume and antral follicle count (AFC) were evaluated on cycle day 3-4. The predictive value of oocyte number and pregnancy were assessed using uni- and multivariate analysis.


RESULTS
Poor responders (<6 oocytes) had significantly lower luteal AMH levels, while high responders (>20 oocytes) had significantly higher AFC, AMH and luteal stimulated inhibin B and estradiol than normal responders. Multivariate regression analyses showed that the best models for predicting oocyte number included AFC, follicular phase AMH and stimulated inhibin B. Only AMH showed a significant difference between pregnant and non-pregnant women at both cycle phases.


CONCLUSIONS
In young women (<38 years), AFC or basal AMH and stimulated inhibin B predict ovarian response for IVF. The only predictor for pregnancy is follicular or luteal phase AMH.
Eldar-Geva
Talia
T
IVF Unit, Department of Obstetrics and Gynecology, Shaare-Zedek Medical Center, Ben Gurion University of the Negev, Jerusalem 91031, Israel. gevat@szmc.org.il
Ben-Chetrit
Avraham
A
Spitz
Irving M
IM
Rabinowitz
Ron
R
Markowitz
Einat
E
Mimoni
Tzvia
T
Gal
Michael
M
Zylber-Haran
Edit
E
Margalioth
Ehud J
EJ
D000328:Adult; D054304:Anti-Mullerian Hormone; D002452:Cell Count; D004958:Estradiol / Q000097:blood*; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000627:therapeutic use*; D005498:Follicular Phase / Q000502:physiology; D006023:Glycoproteins / Q000097:blood*; D006801:Humans; D007265:Inhibins / Q000097:blood*; D008183:Luteal Phase / Q000502:physiology; D009865:Oocytes / Q000166:cytology; D006080:Ovarian Follicle / Q000166:cytology; D010053:Ovary / Q000000981:diagnostic imaging*; D011247:Pregnancy; D011379:Prognosis; D013735:Testicular Hormones / Q000097:blood*; D016896:Treatment Outcome; D014463:Ultrasonography
D006023:Glycoproteins; D013735:Testicular Hormones; C422364:inhibin B; D004958:Estradiol; D007265:Inhibins; D054304:Anti-Mullerian Hormone; D005640:Follicle Stimulating Hormone