title: Anti-Müllerian hormone and antral follicle count for prediction of ovarian stimulation response in polycystic ovary syndrome.
abstract: OBJECTIVE
  To evaluate the ability of a combination of multiple ovarian reserve markers to predict ovarian stimulation response in polycystic ovary syndrome (PCOS).
  
  
  METHODS
  On cycle Day 3 of 75 infertile patients with PCOS, serum follicle stimulating hormone (FSH), luteinizing hormone (LH), and anti-Müllerian hormone (AMH) were measured, and antral follicle count (AFC) and ovarian volume (OV) were evaluated by transvaginal sonography (TVS). All patients underwent the same mild ovarian stimulation protocol using clomiphene citrate and highly purified FSH. Ovulation was monitored by TVS and confirmed by midluteal serum progesterone level.
  
  
  RESULTS
  AMH, AFC, and "ovulation index" [OI, serum AMH (ng/ml) × bilateral AFC] were significantly lower in the ovulatory group (n = 57, 76%) compared with the anovulatory group, whereas LH, FSH, LH/FSH ratio, and OV were not significantly different. Using receiver-operating characteristic curve analysis, the OI at a cutoff value of "85" had a sensitivity of 73.7% and a specificity of 72.2% in the prediction of ovulation, with an area under the curve of 0.733. Patients with OI < 85 had significantly higher ovulation rate (p < 0.001).
  
  
  CONCLUSIONS
  The OI, combining both AMH and AFC, is a potentially useful predictor of the outcome of ovarian stimulation in PCOS.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt. dr_akmalelmazny@yahoo.com
authors.forename: Akmal
authors.initials: A
authors.lastname: El-Mazny
authors.forename: Nermeen
authors.initials: N
authors.lastname: Abou-Salem
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D002452:Cell Count; D002996:Clomiphene / Q000627:therapeutic use; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000175:diagnosis / Q000628:therapy; D006080:Ovarian Follicle / Q000166:cytology*; D010060:Ovulation / Q000097:blood*; D010062:Ovulation Induction / Q000009:adverse effects; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000175:diagnosis* / Q000628:therapy*; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D005300:Fertility Agents, Female; D002996:Clomiphene; D054304:Anti-Mullerian Hormone