Basal serum anti-müllerian hormone and antral follicle count are predictors of ovarian response for Asian women in Singapore

Abstract

To determine the basal ovarian reserve markers for prediction of poor and high responses and clinical pregnancy outcome in subfertile Asian women requiring controlled ovarian stimulation (COS) treatment in Singapore. Subfertile Asian women, aged ≤40 with basal serum follicle stimulating hormone (FSH) level of ≤12 IU/L, were enrolled prospectively during routine preliminary endocrine ovarian reserve assessment prior to COS regime for intracytoplasmic sperm insemination (ICSI) cycles. Basal serum levels of the endocrine ovarian reserve markers (anti-Müllerian hormone (AMH), estradiol, FSH, luteinizing hormone), antral follicle count (AFC) and ovarian response parameters were compared between the Poor (retrieved oocytes ≤4), Normal (retrieved oocytes, 5 to 19) and High Responder (retrieved oocytes ≥20) groups of women. Basal serum AMH and AFC were significantly correlated to age ( r =−0.213 and −0.243, respectively) and to the number of retrieved oocytes ( r =0.570 and 0.523, respectively) ( P <0.05). Both basal serum AMH and AFC were significant discriminators of poor response (cut-off levels of ≤2.0 µg/L and ≤12, respectively) and for high response (AMH ≥3.2 µg/L and AFC of ≥20, respectively) to COS. Basal AMH was the only significant predictor for clinical pregnancy outcome, ROCAUC =0.71, cut-off level of ≥3.0 µg/L and odds ratio of 1.42. Both basal serum AMH and AFC were reliable ovarian reserve markers for predicting poor and high ovarian response to COS in Asian women. Basal AMH was the only significant predictor for clinical pregnancy outcome.