title: Retrospective cohort study: AMH is the best ovarian reserve markers in predicting ovarian response but has unfavorable value in predicting clinical pregnancy in GnRH antagonist protocol.
abstract: BACKGROUND
  Various ovarian reserve markers have been used to predict ovarian response and pregnancy. However, concerning Chinese population, fewer trials have been performed using the combined ovarian reserve markers to predict ovarian response and pregnancy in GnRH antagonist protocols.
  
  
  METHODS
  Data from a total of 373 patients' in vitro fertilization cycles using GnRH antagonist protocol was retrospectively included. According to our center's daily practice, circulating follicle-stimulating hormone, luteinizing hormone, and estradiol (E2) were tested on menstrual cycle day 2-4 or hCG trigger day, and the concentration of AMH was determined despite of menstrual cycle. The antral follicle count (AFC) was assessed by transvaginal ultrasound on day 2-4 of menstrual cycle. Different ovarian response was defined as 0-4 and 5-15 and >15 oocyte retrieved for low and normal and high ovarian response, respectively. Gestational sac with fetal heartbeat detected by ultrasound was considered as clinical pregnancy.
  
  
  RESULTS
  Serum AMH levels was the most accurate marker in predicting ovarian response [area under the receiver operating characteristic (ROC) curve = 0.767]. Significant difference was found in age between non-clinical pregnancy and clinical pregnancy groups (p < 0.001).
  
  
  CONCLUSIONS
  Our data demonstrated that the circulating AMH despite of menstrual cycle was preferable in prediction of oocyte retrieved outcome during GnRH antagonist protocol than age, AFC and the other currently used hormone markers. Furthermore, age is the only marker in predicting clinical pregnancy.
authors.affiliation: Department of Obstetrics and Gynecology, Reproductive Medical Center, Peking University Third Hospital, 49 Huayuan North Road, Haidian District, Beijing, 100191, China.|Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing, China.
authors.forename: Huiyu
authors.initials: H
authors.lastname: Xu
authors.affiliation: Center of Clinical Epidermiology, Peking University Third Hospital, Beijing, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Zeng
authors.affiliation: Department of Obstetrics and Gynecology, Reproductive Medical Center, Peking University Third Hospital, 49 Huayuan North Road, Haidian District, Beijing, 100191, China.|Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Yang
authors.affiliation: Department of Obstetrics and Gynecology, Reproductive Medical Center, Peking University Third Hospital, 49 Huayuan North Road, Haidian District, Beijing, 100191, China.|Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Feng
authors.affiliation: Department of Obstetrics and Gynecology, Reproductive Medical Center, Peking University Third Hospital, 49 Huayuan North Road, Haidian District, Beijing, 100191, China. roseli001@sina.com.|Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing, China. roseli001@sina.com.
authors.forename: Rong
authors.initials: R
authors.lastname: Li
authors.affiliation: Department of Obstetrics and Gynecology, Reproductive Medical Center, Peking University Third Hospital, 49 Huayuan North Road, Haidian District, Beijing, 100191, China. jie.qiao@263.net.|Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing, China. jie.qiao@263.net.
authors.forename: Jie
authors.initials: J
authors.lastname: Qiao
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods; D005640:Follicle Stimulating Hormone / Q000097:blood; D007987:Gonadotropin-Releasing Hormone / Q000037:antagonists & inhibitors*; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D065851:Ovarian Reserve; D010053:Ovary / Q000502:physiology*; D011247:Pregnancy; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol; D054304:Anti-Mullerian Hormone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone
keywords: AFC; AMH; Age; Clinical pregnancy; Ovarian response