title: Ovarian sensitivity index is strongly related to circulating AMH and may be used to predict ovarian response to exogenous gonadotropins in IVF.
abstract: BACKGROUND
  Serum anti-Mullerian hormone (AMH) is currently considered the best marker of ovarian reserve and of ovarian responsiveness to gonadotropins in in-vitro fertilization (IVF). AMH assay, however, is not available in all IVF Units and is quite expensive, a reason that limits its use in developing countries. The aim of this study is to assess whether the "ovarian sensitivity index" precisely reflects AMH so that this index may be used as a surrogate for AMH in prediction of ovarian response during an IVF cycle.
  
  
  METHODS
  AMH serum levels were measured in 61 patients undergoing IVF with a "long" stimulation protocol including the GnRH agonist buserelin and recombinant follicle-stimulating hormone (rFSH). Patients were divided into four subgroups according to the percentile of serum AMH and their ovarian stimulation was prospectively followed. Ovarian sensitivity index (OSI) was calculated dividing the total administered FSH dose by the number of retrieved oocytes.
  
  
  RESULTS
  AMH and OSI show a highly significant negative correlation (r = -0.67; p = 0.0001) that is stronger than the one between AMH and the total number of retrieved oocytes and than the one between AMH and the total FSH dose.
  
  
  CONCLUSIONS
  OSI reflects quite satisfactory the AMH level and may be proposed as a surrogate of AMH assay in predicting ovarian responsiveness to FSH in IVF. Being very easy to calculate and costless, its use could be proposed where AMH measurement is not available or in developing countries where limiting costs is of primary importance.
authors.affiliation: Physiopathology of Reproduction and IVF Unit, University of Torino, S.Anna Hospital, Torino, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Biasoni
authors.forename: Ambra
authors.initials: A
authors.lastname: Patriarca
authors.forename: Paola
authors.initials: P
authors.lastname: Dalmasso
authors.forename: Angela
authors.initials: A
authors.lastname: Bertagna
authors.forename: Chiara
authors.initials: C
authors.lastname: Manieri
authors.forename: Chiara
authors.initials: C
authors.lastname: Benedetto
authors.forename: Alberto
authors.initials: A
authors.lastname: Revelli
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D005640:Follicle Stimulating Hormone / Q000494:pharmacology*; D006801:Humans; D054315:Oocyte Retrieval; D010053:Ovary / Q000187:drug effects / Q000502:physiology; D010062:Ovulation Induction / Q000379:methods
chemical_list: D054304:Anti-Mullerian Hormone; D005640:Follicle Stimulating Hormone