title: Use of ovarian reserve parameters for predicting live births in women undergoing in vitro fertilization.
abstract: OBJECTIVE
  To examine common clinical determinants, including patient age; levels of anti-Müllerian hormone (AMH), inhibin B, and follicle-stimulating hormone (FSH); antral follicle count (AFC); and number of oocytes retrieved, to predict live births in women undergoing in vitro fertilization.
  
  
  METHODS
  Women undergoing cycles of intracytoplasmic sperm injection (ICSI) for the first time were reviewed retrospectively, and serum levels of AMH, inhibin B, and FSH, as well as AFC (days 1 and 4 of pre-ICSI menstrual period) and patient age were analyzed as determinants of live birth rates.
  
  
  RESULTS
  Of the patients studied, 35.71% (891/2495) became pregnant, with live births achieved in 32.20% (806/2495) of cycles initiated and in 46.37% (806/1738) of embryo transfers. Clinical pregnancy rate was 35.71% (891/2495) for cycles initiated and 51.26% (891/2318) for embryo transfers. Univariate analysis revealed that the odds of live birth significantly decreased with increasing age, declining AMH or inhibin B concentrations, and fewer oocytes retrieved. At AMH levels greater than 5.7 ng/ml, the odds of live birth were 3.18 times greater than for AMH levels less than 1.9 ng/ml [95% confidence interval (CI), 1.89-5.43]. Using multivariate logistic regression, only AMH (OR = 1.89; 95% CI, 1.00-3.60; p < 0.05) and AFC (OR = 1.86; 95% CI, 1.02-3.40; p < 0.05) showed statistically significant associations with live birth. Area under the curve for ROC (ROC(AUC)) indicated that AMH (AUC = 0.60) surpassed AFC (AUC = 0.59), number of oocytes retrieved (AUC = 0.59), inhibin B (AUC = 0.55), FSH (ROC(AUC) = 0.54) and chronological age (ROC(AUC) = 0.53) in predicting live birth.
  
  
  CONCLUSIONS
  In this assessment of various indices (i.e., age; levels of AMH, inhibin B, and FSH; AFC; and quantity of oocytes retrieved) for predicting live births for IVF patients, AMH, AFC and the quantity of oocytes retrieved constituted the most reliable determinants.
authors.affiliation: Department of Perinatology, Medical University, Gdańsk, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Lukaszuk
authors.forename: Michał
authors.initials: M
authors.lastname: Kunicki
authors.forename: Joanna
authors.initials: J
authors.lastname: Liss
authors.forename: Mariusz
authors.initials: M
authors.lastname: Lukaszuk
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Jakiel
mesh_terms: D000328:Adult; D000367:Age Factors; D054304:Anti-Mullerian Hormone / Q000097:blood; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000628:therapy*; D007248:Infertility, Male / Q000503:physiopathology; D028322:Inhibin-beta Subunits / Q000097:blood; D050498:Live Birth; D008297:Male; D054315:Oocyte Retrieval; D010053:Ovary / Q000473:pathology / Q000503:physiopathology*; D011247:Pregnancy; D018873:Pregnancy Rate; D016649:Primary Ovarian Insufficiency / Q000097:blood / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D012372:ROC Curve; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic
chemical_list: D015415:Biomarkers; D054304:Anti-Mullerian Hormone; D005640:Follicle Stimulating Hormone; D028322:Inhibin-beta Subunits