title: What is the value of anti-Müllerian hormone in predicting the response to ovarian stimulation with GnRH agonist and antagonist protocols?
abstract: BACKGROUND
  Anti-Müllerian hormone (AMH) is a marker of the ovarian reserve with promising prognostic potential in reproductive medicine. We aimed to evaluate the prognostic ability of AMH for predicting excessive or poor responses to ovarian stimulation using gonadotrophin-releasing hormone (GnRH) agonist and GnRH antagonist protocols in patients undergoing medically assisted reproduction (MAR) procedures.
  
  
  METHODS
  This retrospective analysis included 623 women who underwent ovarian stimulation for medically assisted reproduction. AMH level measurements were acquired from all couples within six months of the initiation of ovarian stimulation.
  
  
  RESULTS
  AMH was significantly correlated with the number of retrieved oocytes, and age was not relevant in a multivariate regression analysis (unstandardized regression coefficient of 1.130, 95 % confidence interval 0.977-1.283). AMH was a better predictor of both excessive (>19 oocytes) and poor (<4 oocytes) ovarian response than age (areas under the curve (AUCs) of 0.882 and 0.816, respectively). When stratified according to the stimulation protocol (a long GnRH agonist versus a GnRH antagonist protocol), AMH retained its high predictive value for excessive and poor responses in both groups. Serum AMH levels exhibited a strong correlation with the level of the response to ovarian stimulation.
  
  
  CONCLUSIONS
  AMH is an independent and an accurate predictor of excessive and poor responses to GnRH agonist and GnRH antagonist protocols for ovarian stimulation.
authors.affiliation: Department of Reproductive Medicine and Gynaecologic Endocrinology, University Medical Centre Maribor, Ljubljanska 5, 2000, Maribor, Slovenia. knez.jure@gmail.com.
authors.forename: Jure
authors.initials: J
authors.lastname: Knez
authors.affiliation: Department of Reproductive Medicine and Gynaecologic Endocrinology, University Medical Centre Maribor, Ljubljanska 5, 2000, Maribor, Slovenia. borut.kov@ukc-mb.si.
authors.forename: Borut
authors.initials: B
authors.lastname: Kovačič
authors.affiliation: Department of Reproductive Medicine and Gynaecologic Endocrinology, University Medical Centre Maribor, Ljubljanska 5, 2000, Maribor, Slovenia. medved.maruska@gmail.com.
authors.forename: Maruška
authors.initials: M
authors.lastname: Medved
authors.affiliation: Department of Reproductive Medicine and Gynaecologic Endocrinology, University Medical Centre Maribor, Ljubljanska 5, 2000, Maribor, Slovenia. vlai@amis.net.
authors.forename: Veljko
authors.initials: V
authors.lastname: Vlaisavljević
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000037:antagonists & inhibitors*; D006727:Hormone Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D006080:Ovarian Follicle / Q000187:drug effects; D010062:Ovulation Induction / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D006727:Hormone Antagonists; D007987:Gonadotropin-Releasing Hormone; D054304:Anti-Mullerian Hormone