title: Anti-Müllerian hormone for the assessment of ovarian response in GnRH-antagonist-treated oocyte donors.
abstract: Evidence regarding the role of anti-Müllerian hormone (AMH) among oocyte donors is limited and only involves gonadotrophin-releasing hormone (GnRH)-agonist-treated donors. This trial assessed the predictive ability of AMH for ovarian response among 108 oocyte donors treated with an antagonist protocol. In multivariate linear regression analysis, both AMH and age were independently associated with ovarian response (unstandardized coefficients 0.904 and -0.378, respectively). In receiver operating characteristic curve analysis, AMH performed better than age, but was a modest predictive marker for low (≤ 6 oocytes) and excessive (>20 oocytes) ovarian response (area under the curve (AUC) 0.643 and 0.695, respectively). Similarly, a multivariate logistic model including AMH and age was also modest (AUC 0.651 and 0.697 for low and excessive responders, respectively). The predictive ability of AMH did not significantly alter when different thresholds were adopted, such as <4 oocytes for low response and >25 for excessive response (AUC 0.759 and 0.724, respectively). Among oocyte donors treated with a GnRH-antagonist protocol, although AMH was correlated with the number of oocytes retrieved, it demonstrates a modest ability in discriminating women with low or excessive ovarian response. Selection of oocyte donors is of paramount importance for the proper and more cost-efficient functionality of the oocyte donation programme. Despite the extensive literature regarding the efficacy of anti-Müllerian hormone (AMH) for predicting ovarian response among infertile patients, available evidence regarding the role of AMH in oocyte donors is considerably limited and involves only agonist down-regulated cycles. In this trial we assessed whether AMH can be considered a predictive marker for ovarian response among oocyte donors treated with a gonadotrophin-releasing hormone (GnRH)-antagonist protocol. According to our results, among oocyte donors treated with a GnRH-antagonist protocol, although AMH was correlated with the number of oocytes retrieved, the correlation is not strong and it appears that AMH has a modest predictive ability to discriminate women who are likely to demonstrate either impaired or excessive response to ovarian stimulation.
authors.affiliation: Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium. n.polyzos@gmail.com
authors.forename: Nikolaos P
authors.initials: NP
authors.lastname: Polyzos
authors.forename: Dominic
authors.initials: D
authors.lastname: Stoop
authors.forename: Christophe
authors.initials: C
authors.lastname: Blockeel
authors.forename: Paul
authors.initials: P
authors.lastname: Adriaensen
authors.forename: Peter
authors.initials: P
authors.lastname: Platteau
authors.forename: Ellen
authors.initials: E
authors.lastname: Anckaert
authors.forename: Johan
authors.initials: J
authors.lastname: Smitz
authors.forename: Paul
authors.initials: P
authors.lastname: Devroey
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives* / Q000037:antagonists & inhibitors* / Q000494:pharmacology; D006801:Humans; D054315:Oocyte Retrieval; D017063:Outcome Assessment, Health Care; D010053:Ovary / Q000187:drug effects*; D010062:Ovulation Induction / Q000379:methods; D011237:Predictive Value of Tests; D012372:ROC Curve; D012044:Regression Analysis; D012189:Retrospective Studies; D014019:Tissue Donors
chemical_list: D015415:Biomarkers; D007987:Gonadotropin-Releasing Hormone; D054304:Anti-Mullerian Hormone; C061018:ganirelix