title: Anti-Mullerian hormone is a better marker than inhibin B, follicle stimulating hormone, estradiol or antral follicle count in predicting the outcome of in vitro fertilization.
abstract: OBJECTIVE
  The present study aims to compare anti-Mullerian hormone (AMH) with other ovarian reserve markers and to find a cut-off value of AMH for predicting ovarian response towards controlled ovarian hyperstimulation in an in vitro fertilization (IVF) program.
  
  
  METHODS
  A prospective analysis was performed in 180 patients undergoing their first IVF trial, which is being conducted at a department of assisted reproduction in a tertiary medical center. The main outcome measures were determined as age and antral follicle count as well as the serum concentrations of follicle stimulating hormone, luteinizing hormone (LH), estradiol (E2), inhibin B and AMH. The predictive power of the aforementioned measures in specifying ovarian response was determined by means of discriminate analyses.
  
  
  RESULTS
  As expected, day 3 LH levels were significantly high in the poor responder group. The poor responders had significantly lower antral follicle counts, retrieved oocyte number, and mature oocyte counts as well as day 3 AMH levels (5.8 ± 2.32 vs. 1.8 ± 0.80 ng/ml). There was a positive correlation with antral follicle count, basal AMH, E2 and follicle count on the day of HCG administration and negative correlation with age. The AMH level was addressed as the only significant factor in determination of mature oocyte number. A cut-off point for serum AMH concentration indicating the value of 2.97 ng/ml was found to predict the poor ovarian response with a sensitivity of 100.0% and a specificity of 89.6%. However, the same cut-off point was not as predictive for the non-conception circumstance.
  
  
  CONCLUSIONS
  The present study concludes that AMH is a promising biochemical marker for the prediction of ovarian response and that a cut-off point indicating the value of 2.97 ng/ml can be adopted for this prediction.
authors.affiliation: Department of Assisted Reproduction Technology, Dr. Zekai Tahir Burak Women Health Research and Education Hospital, Yunus Emre Mah., Dereboyu Sok. No: 71/2 Yenimahalle 06170, Ankara, Turkey.
authors.forename: Cigdem
authors.initials: C
authors.lastname: Kunt
authors.forename: Gulnur
authors.initials: G
authors.lastname: Ozaksit
authors.forename: Raziye
authors.initials: R
authors.lastname: Keskin Kurt
authors.forename: Ayse Nur
authors.initials: AN
authors.lastname: Cakir Gungor
authors.forename: Mine
authors.initials: M
authors.lastname: Kanat-Pektas
authors.forename: Sevtap
authors.initials: S
authors.lastname: Kilic
authors.forename: Arzu
authors.initials: A
authors.lastname: Dede
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D019160:Endosonography; D004958:Estradiol / Q000097:blood*; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006801:Humans; D007231:Infant, Newborn; D007247:Infertility, Female / Q000000981:diagnostic imaging / Q000628:therapy*; D007265:Inhibins / Q000097:blood*; D006080:Ovarian Follicle / Q000000981:diagnostic imaging*; D010062:Ovulation Induction; D011085:Polycystic Ovary Syndrome / Q000000981:diagnostic imaging / Q000628:therapy; D011237:Predictive Value of Tests; D011247:Pregnancy; D011379:Prognosis; D011446:Prospective Studies
chemical_list: C422364:inhibin B; D004958:Estradiol; D007265:Inhibins; D054304:Anti-Mullerian Hormone; D005640:Follicle Stimulating Hormone