Predicting ovarian reserve and reproductive outcome using antimüllerian hormone (AMH) and antral follicle count (AFC) in patients with previous assisted reproduction technique (ART) failure.
OBJECTIVE
The main objective of our prospective, observational, analytical research work was to determine whether Anti-Müllerian hormone (AMH) and antral follicle count (AFC) could be effectively used as predictors of ovarian reserve and, possibly, of reproductive outcome with ART.


METHODS
We studied 143 IVF/ET cycles in patients with a previous history of ART failure, all of them supposed to be of poor prognosis, who had agreed to another ART attempt after knowing their AMH, AFC, and base hormone (FSH, LH, 17 beta-estradiol) levels.


RESULTS
AMH and AFC showed a positive correlation with the number of oocytes retrieved (p = 0.0016) and (p < 0.0001), respectively and with percentage of MII oocytes, (p = 0.00756) and (p < 0.001). The combined use of these markers showed an area under the curve of 82.2% for oocytes retrieved. Our results shows a very high cancelation (22% of started cycles) and very low pregnancy rates (6.7% and 9.8%) in low and normoresponders, respectively.


CONCLUSIONS
AMH levels and AFC are reliable indicators of ovarian reserve. Patients with ovarian reserve levels that predict a very low probability of success should be informed that the poor prognosis associated with these values may not justify the expense of IVF/ET.
Department of Obstetrics and Gynecology, University of Valencia School of Medicine, Valencia, Spain. profesorbonillamusoles@hotmail.com
F
F
Bonilla-Musoles
J C
JC
Castillo
O
O
Caballero
J
J
Pérez-Panades
F
F
Bonilla
M
M
Dolz
N
N
Osborne
D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D021621:Imaging, Three-Dimensional; D007986:Luteinizing Hormone / Q000097:blood; D010053:Ovary / Q000166:cytology* / Q000000981:diagnostic imaging / Q000502:physiology; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D027724:Reproductive Techniques, Assisted; D017211:Treatment Failure; D014463:Ultrasonography
D015415:Biomarkers; D004958:Estradiol; D054304:Anti-Mullerian Hormone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone