title: Predictors of ovarian response in women treated with corifollitropin alfa for in vitro fertilization/intracytoplasmic sperm injection.
abstract: OBJECTIVE
  To identify predictors of ovarian response in women undergoing ovarian stimulation with corifollitropin alfa in a GnRH antagonist protocol and determine specific thresholds for the prediction of low and excessive responders.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  University-based tertiary care center.
  
  
  METHODS
  Infertile women undergoing ovarian stimulation for in vitro fertilization/intracytoplasmic sperm injection.
  
  
  METHODS
  Controlled ovarian hyperstimulation with corifollitropin alfa in a GnRH antagonist protocol.
  
  
  METHODS
  Relationship between ovarian reserve tests and ovarian response.
  
  
  RESULTS
  Antimüllerian hormone (AMH) and antral follicle count (AFC) were the only independent predictors for low and excessive ovarian response. In prediction of excessive response, the area under the receiver operating characteristic curve [AUC (95% CI)] for AMH was 0.890 (0.832-0.947) and 0.897 (0.829-0.964) for AFC. The optimal thresholds for identifying excessive responders were 3.52 ng/mL for AMH (sensitivity 89.5, specificity 83.8) and 16 for AFC (sensitivity 80.0, specificity 84.5). AMH and AFC also predicted low ovarian response: AUCs AMH 0.836 (0.783-0.889) and AFC 0.830 (0.767-0.894). The optimal thresholds for predicting low response were 1.37 ng/mL for AMH (sensitivity 74.1, specificity 77.5) and 8 for AFC (sensitivity 72.2, specificity 84.6). For both excessive and low ovarian responses, a logistic regression model combining the biomarkers was associated with improved discrimination.
  
  
  CONCLUSIONS
  AMH and AFC are the best predictors for low and excessive response in women treated with corifollitropin alfa in an antagonist protocol. Using AMH and AFC to select suitable candidates for treatment with corifollitropin alfa may result in a safe and convenient stimulation.
authors.affiliation: Center 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: Herman
authors.initials: H
authors.lastname: Tournaye
authors.forename: Luis
authors.initials: L
authors.lastname: Guzman
authors.forename: Michel
authors.initials: M
authors.lastname: Camus
authors.forename: Scott M
authors.initials: SM
authors.lastname: Nelson
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use; D005307:Fertilization in Vitro / Q000009:adverse effects / Q000379:methods; D043373:Follicle Stimulating Hormone, Human / Q000627:therapeutic use*; D006801:Humans; D007247:Infertility, Female / Q000628:therapy; D008297:Male; D054315:Oocyte Retrieval / Q000706:statistics & numerical data; D016471:Ovarian Hyperstimulation Syndrome / Q000175:diagnosis / Q000209:etiology; D010053:Ovary / Q000187:drug effects* / Q000502:physiology; D010062:Ovulation Induction / Q000009:adverse effects / Q000379:methods*; D011247:Pregnancy; D011379:Prognosis; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D005300:Fertility Agents, Female; D043373:Follicle Stimulating Hormone, Human; C437186:follicle stimulating hormone, human, with HCG C-terminal peptide
keywords: AFC; AMH; Corifollitropin alfa; OHSS; antimüllerian hormone; poor responders