title: Is AMH useful to reduce low ovarian response to GnRH antagonist protocol in oocyte donors?
abstract: We aimed to establish the reference values of Anti-Müllerian hormone (AMH) in our oocyte donor population and correlate them with the ovarian response to an antagonist stimulation protocol and to study the predictive capacity of AMH for poor response (PR). Normal AMH curves were obtained for 172 candidates. AMH levels decreased with age although they showed great heterogeneity and spread in absolute values at any age range. AMH levels showed a positive correlation, statistically significant, with the Antral Follicle Count (r = 0,705), and number of oocytes retrieved (r = 0,356). In receiver operating characteristic curve analysis a threshold value of AMH = 2.31 ng/ml predictive for retrieval <6 MII (area under the curve (AUC) 0.675) was identified. This cut-off predicted PR with a sensitivity of 70.4% and a specificity of 61.8%, (PPV = 39.6%; NPV = 85.5%, p = 0.004). When performing a multiple logistic regression analysis including age, AFC and FSH, an AUC = 0.668 for PR was obtained whereas if AMH was added to the model it resulted in an AUC = 0.713. In oocyte donors aged 18 to 35 with an AFC ≥ 10 and basal FSH <10 mIU/ml, measuring AMH levels improved just slightly the prediction for PR.
authors.affiliation: Department of Obstetrics, Gynaecology and Reproduction, Institut Universitari Dexeus, Barcelona, Spain. pacmar@dexeus.com
authors.forename: Francisca
authors.initials: F
authors.lastname: Martínez
authors.forename: Elisabet
authors.initials: E
authors.lastname: Clua
authors.forename: Olga
authors.initials: O
authors.lastname: Carreras
authors.forename: Rosa
authors.initials: R
authors.lastname: Tur
authors.forename: Ignacio
authors.initials: I
authors.lastname: Rodríguez
authors.forename: Pere N
authors.initials: PN
authors.lastname: Barri
mesh_terms: D000293:Adolescent; D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood / Q000502:physiology*; D054316:Biomarkers, Pharmacological / Q000097:blood; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D007987:Gonadotropin-Releasing Hormone / Q000037:antagonists & inhibitors*; D006727:Hormone Antagonists / Q000627:therapeutic use*; D006801:Humans; D018587:Oocyte Donation / Q000379:methods / Q000706:statistics & numerical data; D054315:Oocyte Retrieval / Q000706:statistics & numerical data; D010060:Ovulation / Q000097:blood* / Q000187:drug effects; D010062:Ovulation Induction / Q000379:methods*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D054316:Biomarkers, Pharmacological; D005300:Fertility Agents, Female; D006727:Hormone Antagonists; D007987:Gonadotropin-Releasing Hormone; D054304:Anti-Mullerian Hormone