Abstract
To evaluate the use of anti-mullerian hormone (AMH) and basal antral follicle count (AFC) as a predictor of ovarian reserve and ovarian response to controlled ovarian hyperstimulation (COH) in women with hypogonadotropic hypogonadism (HH). This is a retrospective cohort study consisted of the files of 40 women attended a university IVF center during the past 4 years. Nineteen patients has been diagnosed as HH, compared to 21 patients diagnosed as premature ovarian failure (POF). We evaluated the use of AMH value and basal AFC to predict the ovarian reserve and ovarian response to COH in HH women; women with POF have been involved as a control group. We reviewed the recorded AMH and basal AFC, and the total number of retrieved oocytes and fertilized ones in both groups. We used unpaired student t-test for statistical comparison. P<0.05 was considered for statistical significance. Both groups were similar in age, BMI, AMH and basal AFC. Basal FSH and LH were higher in the POF group. Despite the low AMH and the low basal AFC in women with HH ( average 0.46 and 1.6 respectively), we report significant high number of retrieved oocytes and fertilized ones in response to high dose of gonadotropins stimulation compared to the reverse in the POF group. (Table 1) Pregnancy has been reported in 9 women (out of 19) in the HH group. Only one woman (out of 21) got pregnant in the POF group.Table 1Baseline characters and response to COH in women with HH Vs. POF.HH (n=19)POF (n=21)P valueAge26.3323.550.15BMI22.724.90.08FSH0.8724.9<0.001LH0.7521.5<0.001AMH0.460.290.11AFC1.60.910.34Total gonadotrophin dose560040810.03Peak E23344.4427.3<0.001Total retrieved oocytes12.81.3<0.001Total fertilized oocytes8.10.45<0.001 Open table in a new tab AMH and basal AFC has limited value in women with HH regarding prediction of ovarian reserve and ovarian response to COH. Higher doses of gonadotropins can be used rather than early giving up.
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