The role of inhibin B in prediction of in vitro fertilization or intracytoplasmic sperm injection cycles' outcome.
OBJECTIVE
To investigate the usefulness of inhibin B concentrations obtained on the fifth day in predicting ovarian response and assisted reproductive technologies outcome.


METHODS
In this prospective multi-center study, infertile women who were candidate for in vitro fertilization or intracytoplasmic sperm injection for the first time were enrolled. These patients were referred to the Royan Institute, Vali-Asr Hospital and Alvand Hospital, Tehran, Iran between 2003 and 2004. The inclusion criteria were female age (20-35 years), body mass index (BMI) of 20-28 Kg/m2, duration of infertility>2 years, a normal menstrual cycle and a normal day 3 follicle stimulating hormone level of <8.5 IU/l. All patients underwent long standard gonadotrophin releasing hormone agonist protocol. Plasma level of inhibin B was checked on the fifth day of menstrual cycle. The diagnostic accuracy of inhibin B, were assessed by the area under the receiver operating characteristic (ROC) curve.


RESULTS
In this study, 107 infertile patients were studied. Using the value of 283 pg/ml for inhibin B as the cut-off point, day 5 inhibin B had 77% sensitivity, 30% specificity, 31.2% positive predictive values (PPV) and 76.7% negative predictive values (NPV) for poor ovarian response. There were statistically significant correlation among day 5 inhibin B concentration and BMI, number of mature follicles, retrieved oocytes, developed and transferred embryos, chemical pregnancy, ovarian hyperstimulation syndrome (OHSS) and poor responder.


CONCLUSIONS
Although the chemical pregnancy, number of retrieved oocytes, developed and transferred embryos were higher in patients with higher day 5 inhibin B concentration but considering its sensitivity, specifity, PPV and NPV, it cannot be used as a strong test for prediction of cancellation, pregnancy, poor responses and OHSS.
Tehraninejad
Ensieh S
ES
Department of Endocrinology and Female Infertility, Royan Institute, Simin Alley, PO Box 19395-4644, Assef Cross, Zaferanieh, Tehran, Iran. tehraninejad@royaninstitute.org
Amirchaghmaghi
Elham
E
Owj
Monir
M
Rashidi
Batol H
BH
Jalilian
Nasrin
N
Sadeghi
Maria
M
D000328:Adult; D015415:Biomarkers / Q000097:blood*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007265:Inhibins / Q000097:blood*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D020554:Sperm Injections, Intracytoplasmic; D016896:Treatment Outcome
D015415:Biomarkers; C422364:inhibin B; D007265:Inhibins