title: Serum anti-Müllerian hormone and antral follicle count as predictive markers of OHSS in ART cycles.
abstract: OBJECTIVE
  To evaluate predictive role of day-3 serum anti-Müllerian hormone (AMH) levels and antral follicle count (AFC) in ovarian hyperstimulation syndrome (OHSS) in patients undergoing IVF/ICSI cycles.
  
  
  METHODS
  Forty-one women with moderate/severe OHSS and 41 age matched women without OHSS were compared to evaluate the predictive value of certain risk factors for OHSS. AFC, and E(2), FSH, LH, AMH, inhibin-B levels measured on day 3 of the menstrual cycle before controlled ovarian hyperstimulation.
  
  
  RESULTS
  Mean FSH was significantly lower (p < 0.0001); and mean LH, AFC and AMH were significantly higher in women with OHSS compared to women without OHSS (p = 0.049, p < 0.0001 and p < 0.0001, respectively). There was no significant difference in inhibin B (p = 0.112) and estradiol (p = 0.706) between the groups. The ROC area under curve (AUC) for AMH presented the largest AUC among the listed risk factors. AMH (AUC = 0.87) and AFC (AUC = 0.74) had moderate accuracy for predicting OHSS while Inhibin B (AUC = 0.58) and LH (AUC = 0.61) had low accuracy. The cut-off value for AMH 3.3 ng/mL provided the highest sensitivity (90%) and specificity (71%) for predicting OHSS. It's positive (PPV) and negative predictive values (NPV) were 61% and 94%, respectively. The cut-off value for AFC was 8 with 78% sensitivity, 65% specificity, 52% PPV and 86% NPV.
  
  
  CONCLUSIONS
  Measurement of basal serum AMH and AFC can be used to determine the women with high risk for OHSS.
authors: Department of Obstetrics and Gynecology, IVF Unit, Cerrahpasa Medical School, Istanbul University, Fatih, Istanbul, Turkey. drpelinocal@hotmail.com
authors: Pelin
authors: P
authors: Ocal
authors: Sezai
authors: S
authors: Sahmay
authors: Meral
authors: M
authors: Cetin
authors: Tulay
authors: T
authors: Irez
authors: Onur
authors: O
authors: Guralp
authors: Ismail
authors: I
authors: Cepni
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002452:Cell Count; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007265:Inhibins / Q000097:blood; D008875:Middle Aged; D006080:Ovarian Follicle / Q000473:pathology / Q000502:physiology*; D016471:Ovarian Hyperstimulation Syndrome / Q000378:metabolism* / Q000473:pathology; D027724:Reproductive Techniques, Assisted
chemical_list: D015415:Biomarkers; C422364:inhibin B; D007265:Inhibins; D054304:Anti-Mullerian Hormone; D005640:Follicle Stimulating Hormone