title: Ovarian response to 150 µg corifollitropin alfa in a GnRH-antagonist multiple-dose protocol: a prospective cohort study.
abstract: The incidence of low (<6 oocytes) and high (>18 oocytes) ovarian response to 150 µg corifollitropin alfa in relation to anti-Müllerian hormone (AMH) and other biomarkers was studied in a multi-centre (n = 5), multi-national, prospective, investigator-initiated, observational cohort study. Infertile women (n = 212), body weight >60 kg, underwent controlled ovarian stimulation in a gonadotrophin-releasing hormone-antagonist multiple-dose protocol. Demographic, sonographic and endocrine parameters were prospectively assessed on cycle day 2 or 3 of a spontaneous menstruation before the administration of 150 µg corifollitropin alfa. Serum AMH showed the best correlation with the number of oocytes obtained among all predictor variables. In receiver-operating characteristic analysis, AMH at a threshold of 0.91 ng/ml showed a sensitivity of 82.4%, specificity of 82.4%, positive predictive value 52.9%and negative predictive value 95.1% for predicting low response (area under the curve [AUC], 95% CI; P-value: 0.853, 0.769-0.936; <0.0001). For predicting high response, the optimal threshold for AMH was 2.58 ng/ml, relating to a sensitivity of 80.0%, specificity 82.1%, positive predictive value 42.5% and negative predictive value 96.1% (AUC, 95% CI; P-value: 0.871, 0.787-0.955; <0.0001). In conclusion, patients with serum AMH concentrations between approximately 0.9 and 2.6 ng/ml were unlikely to show extremes of response.
authors.affiliation: Department of Reproductive Medicine and Gynecological Endocrinology, University Hospital of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany.
authors.forename: Tamara
authors.initials: T
authors.lastname: Lerman
authors.affiliation: Department of Reproductive Medicine and Gynecological Endocrinology, University Hospital of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany.
authors.forename: Marion
authors.initials: M
authors.lastname: Depenbusch
authors.affiliation: Department of Reproductive Medicine and Gynecological Endocrinology, University Hospital of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany.
authors.forename: Askan
authors.initials: A
authors.lastname: Schultze-Mosgau
authors.affiliation: Universitaeres Kinderwunschzentrum Kiel, Kiel, Germany.
authors.forename: Soeren
authors.initials: S
authors.lastname: von Otte
authors.affiliation: Institute for Medical Biometrics and Statistics, University of Luebeck, Luebeck, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Scheinhardt
authors.affiliation: Institute for Medical Biometrics and Statistics, University of Luebeck, Luebeck, Germany.
authors.forename: Inke
authors.initials: I
authors.lastname: Koenig
authors.affiliation: Kinderwunschzentrum Muenster, Muenster, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Kamischke
authors.affiliation: Department of Biology and Medical Genetics, University Hospital Motol, Prague, Czech Republic.
authors.forename: Milan
authors.initials: M
authors.lastname: Macek
authors.affiliation: Klinikk Hausken, Haugesund, Norway.
authors.forename: Arne
authors.initials: A
authors.lastname: Schwennicke
authors.affiliation: Amedes Experts Hamburg, Hamburg, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Segerer
authors.affiliation: Department of Reproductive Medicine and Gynecological Endocrinology, University Hospital of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany. Electronic address: georg.griesinger@uni-luebeck.de.
authors.forename: Georg
authors.initials: G
authors.lastname: Griesinger
mesh_terms: D000328:Adult; D004334:Drug Administration Schedule; D005260:Female; D043373:Follicle Stimulating Hormone, Human / Q000494:pharmacology*; D007987:Gonadotropin-Releasing Hormone / Q000037:antagonists & inhibitors*; D006801:Humans; D008297:Male; D010053:Ovary / Q000187:drug effects*; D011446:Prospective Studies
chemical_list: D043373:Follicle Stimulating Hormone, Human; C437186:follicle stimulating hormone, human, with HCG C-terminal peptide; D007987:Gonadotropin-Releasing Hormone
keywords: Corifollitropin alfa; GnRH antagonist; Ovarian hyperstimulation syndrome; Ovarian stimulation; Poor response; Response prediction