title: Prediction of assisted reproductive technique outcome in elevated early follicular phase follicle stimulating hormone with Mullerian inhibiting substance level.
abstract: BACKGROUND
  Detection of best predictor of ovarian reserve in patients with temporarily or consistently elevated early follicular phase serum levels of FSH is one of the most important goals in assisted reproductive technique (ART).
  
  
  OBJECTIVE
  To evaluate whether high level of anti-mullerian hormone level is related to success of ART in patients with temporarily or consistently elevated early follicular phase serum levels of FSH.
  
  
  METHODS
  Sixty three women underwent intracytoplasmic sperm injection (ICSI) with GnRH-agonist long protocol or intrauterine insemination (IUI) in a prospective cohort study. FSH, inhibin B and anti-Mullerian hormone (AMH) levels were measured in these women whom were divided to three groups (persistently elevated FSH, variably elevated FSH and, normal FSH level). Basal characteristics, stimulation parameters, and pregnancy occurrence were evaluated.
  
  
  RESULTS
  AMH was significantly higher in women with persistently elevated early follicular phase FSH achieving pregnancy. Women with normal FSH did not have significant difference in AMH level between conceived and non conceived cycles. Women with only one elevated early follicular phase FSH achieving pregnancy did not have significant difference in AMH level with non pregnant women. Response to gonadotropin stimulation, recommendation to oocyte donation significantly differed between the groups.
  
  
  CONCLUSIONS
  This study has demonstrated that relatively young women with persistently or intermittently elevated day 3 FSH levels have diminished ovarian reserve and lower ART success. However, in women whose FSH levels were constantly elevated, AMH (not inhibin B) concentrations were significantly higher in ART cycles resulting in pregnancy. Therefore, AMH level is a good predictor of ART outcome in patients with elevated early follicular phase serum levels of FSH.
authors.affiliation: Department of Obstetrics, Gynecology and Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Leili
authors.initials: L
authors.lastname: Safdarian
authors.affiliation: Department of Obstetrics, Gynecology and Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Khayatzadeh
authors.affiliation: Department of Obstetrics, Gynecology and Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Ebrahim
authors.initials: E
authors.lastname: Djavadi
authors.affiliation: Department of Obstetrics, Gynecology and Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Atossa
authors.initials: A
authors.lastname: Mahdavi
authors.affiliation: Department of Obstetrics, Gynecology and Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Marzieh
authors.initials: M
authors.lastname: Aghahosseini
authors.affiliation: Department of Obstetrics, Gynecology and Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Ashraf
authors.initials: A
authors.lastname: Aleyasin
authors.affiliation: Department of Obstetrics, Gynecology and Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Parvin
authors.initials: P
authors.lastname: Fallahi
authors.affiliation: Department of Obstetrics, Gynecology and Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Sima
authors.initials: S
authors.lastname: Khayatzadeh
authors.affiliation: Department of Obstetrics, Gynecology and Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Arash
authors.initials: A
authors.lastname: Ahmadzadeh
authors.affiliation: Department of Obstetrics, Gynecology and Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohhamad Bagher
authors.initials: MB
authors.lastname: Larijani
keywords: Anti-mullerian hormone; Assisted reproductive technique; In-vitro fertilization; Inhibin B