title: Correlations between anti-müllerian hormone, inhibin B, and activin A in follicular fluid in IVF/ICSI patients for assessing the maturation and developmental potential of oocytes.
abstract: OBJECTIVE
  The objective of the present study was to evaluate the correlation between anti-müllerian hormone (AMH), inhibin B, and activin A in follicular fluid from patients receiving treatment with in-vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), to identify a parameter to assess the maturation and developmental potential of oocytes. -
  
  
  METHODS
  AMH, inhibin B, and activin A were measured in follicular fluid from 27 patients undergoing IVF/ICSI treatment for male-factor infertility, tubal occlusion, endometriosis, or anovulation. The values were correlated with the serum estradiol level, the numbers and maturation of the oocytes, and the outcome of IVF/ICSI. -
  
  
  RESULTS
  A positive correlation was found between AMH in follicular fluid and the number of oocytes retrieved. High inhibin B levels in follicular fluid and high serum E subset2 levels indicated a normal ovarian response to stimulation, corresponding to the oocyte numbers, while low inhibin B and 17-beta-estradiol (E subset2) levels indicated poor responders to stimulation. An activin A/inhibin B ratio of less than 1 and very high inhibin B levels correlated with large numbers of oocytes, while a ratio of 1-2 and high inhibin levels correlated with regular numbers of oocytes. An activin/inhibin ratio of more than 3 and low inhibin levels were found in poor responders. Pregnancies occurred predominantly in the group with a normal or high response. Patients with elevated ratios for 17-beta-estradiol/AMH, oocyte numbers/AMH, and metaphase II oocyte numbers/AMH had the best chances of becoming pregnant, indicating an inverse correlation between AMH and the maturation and developmental potential of the oocytes. -
  
  
  CONCLUSIONS
  In IVF/ICSI patients, a positive correlation was found between AMH, inhibin B, and the activin A/inhibin B ratio in follicular fluid, on the one hand; and between serum 17-beta-estradiol levels and the numbers of oocytes retrieved, on the other. The activin A/inhibin B ratio correlated with the number of oocytes retrieved. The ratio for 17-beta-estradiol, oocyte numbers, and metaphase II oocytes relative to AMH indicated the best developmental potential, and it can therefore be assumed that there is a negative correlation between AMH levels and the maturation and quality of oocytes.
authors.affiliation: Dept. of Obstetrics and Gynecology, Laboratory for Molecular Medicine, University Clinics, Erlangen, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Cupisti
authors.forename: Ralf
authors.initials: R
authors.lastname: Dittrich
authors.forename: A
authors.initials: A
authors.lastname: Mueller
authors.forename: R
authors.initials: R
authors.lastname: Strick
authors.forename: E
authors.initials: E
authors.lastname: Stiegler
authors.forename: H
authors.initials: H
authors.lastname: Binder
authors.forename: M W
authors.initials: MW
authors.lastname: Beckmann
authors.forename: P
authors.initials: P
authors.lastname: Strissel
mesh_terms: D028341:Activins / Q000032:analysis*; D000328:Adult; D054304:Anti-Mullerian Hormone / Q000032:analysis*; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D015571:Follicular Fluid / Q000737:chemistry*; D006801:Humans; D007265:Inhibins / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D009865:Oocytes / Q000254:growth & development*; D011247:Pregnancy; D018873:Pregnancy Rate; D020554:Sperm Injections, Intracytoplasmic
chemical_list: C422405:activin A; C422364:inhibin B; D028341:Activins; D004958:Estradiol; D007265:Inhibins; D054304:Anti-Mullerian Hormone