Evaluation of anti-Müllerian hormone as a test for the prediction of ovarian reserve.
OBJECTIVE
To compare in an integral way the value of the basal serum anti-Müllerian hormone (AMH) level with most of the established ovarian reserve tests.


METHODS
Prospective randomized controlled trial.


METHODS
Fertility center of a university hospital in the Netherlands.


METHODS
One hundred ten patients undergoing their first IVF cycle who were randomized, by a computer-designed four-block system, into two groups.


METHODS
Fifty-six patients underwent a clomiphene citrate challenge test (CCCT), and 54 patients underwent an exogenous FSH ovarian reserve test (EFORT). In all patients, basal AMH, basal FSH, basal inhibin B, antral follicle count (AFC), and basal volume of the ovaries were measured. In all patients, the test was followed by a standard IVF treatment.


METHODS
Ovarian response after ovarian hyperstimulation in an IVF treatment, expressed as the total number of stimulated follicles, retrieved oocytes, and ongoing pregnancies.


RESULTS
The best prediction of ovarian reserve (Y) was seen in a multiple regression prediction model that simultaneously included AFC, inhibin B increment in the EFORT, and basal volume of the ovaries. Univariate logistic regression showed that the best predictors for poor response were AMH, the CCCT, basal FSH, and the AFC. For hyperresponse, univariate logistic regression showed that the best predictor was AFC. Multiple logistic regression analysis did not produce a better model in terms of improving the prediction of poor response or hyperresponse. The best predictors for the prediction of non-pregnancy were the CCCT and the E(2) increment in the EFORT.


CONCLUSIONS
Anti-Müllerian hormone is comparable with other commonly used ovarian reserve tests but is probably most applicable in general practice.
Kwee
Janet
J
Division of Reproductive Endocrinology and Fertility and IVF Centre, department of Obstetrics and Gynaecology, Vrije Universiteit Medical Centre, Amsterdam, The Netherlands. j.kwee@slaz.nl
Schats
Roel
R
McDonnell
Joseph
J
Themmen
Axel
A
de Jong
Frank
F
Lambalk
Cornelis
C
D000293:Adolescent; D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D002996:Clomiphene; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D005640:Follicle Stimulating Hormone; D006801:Humans; D010053:Ovary / Q000187:drug effects / Q000502:physiology*; D010062:Ovulation Induction / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D002996:Clomiphene; D054304:Anti-Mullerian Hormone; D005640:Follicle Stimulating Hormone