Abstract
Background: Prediction of ovarian response is one of the prerequisites for women undergoing intracytoplasmic sperm injection (ICSI) treatment prior to the first controlled ovarian stimulation (COS) cycle. Predictive factors may be variable in patients pre-treated with oral contraceptives (OC) for scheduling purposes. Objective: To evaluate antral follicle count (AFC), anti-müllerian hormone (AMH) and basal follicle stimulating hormone (FSH) for predicting ovarian responses in patients under controlled ovarian hyperstimulation randomized to receive either oral contraceptives (OC) or no treatment (non-OC) prior to their first controlled ovarian stimulation (COS) cycle. Study Design: One hundred infertile women randomized to receive OC treatment or no treatment, prior to their first COS cycle; were stimulated with Gonadotropin Releasing Hormone (GnRH) antagonist protocol. During the early follicular phase (day 2) of the two subsequent cycles (cycle A & cycle B) sonographic (AFC, ovarian volume) and endocrine data (AMH, basal FSH) were recorded. Transvaginal ultrasound was performed for all patients to monitor the ovarian response. Total number of oocytes retrieved and number of generated embryos were recorded and patients were categorized according to retrieved oocytes as poor (oocytes 12). Result(s): AFC, AMH and basal FSH were lower in users than in non-users of hormonal contraception. Poor responders showed less number of oocytes retrieved and had lower AFC and AMH but a higher basal FSH level was recorded in both groups (OC and non-OC). Conclusion: The better predictive value of AMH or AFC, as a single test or in combination will prevent cycle cancellations due to too low or too high ovarian response. AMH in OC group is not affected by OC pretreatment and is superior to other parameters, while AFC is superior to AMH and basal FSH in non-OC group.
Highlights
One of the prerequisites for women undergoing intracytoplasmic sperm injection (ICSI) treatment is the fertility potential of women which is dependent on the quantity and the quality of the ovarian reserve (OR) [1].The first indicator of the OR taken into consideration is the age of women
In the oral contraceptives (OC) group sonographic and endocrine predictive factors were still slightly reduced when compared at stimulation day 1 with those at the start of OC pre-treatment
On the other hand a lower correlation was found for Total ovarian volume between cycles A and B in comparison with the non-OC group
Summary
One of the prerequisites for women undergoing intracytoplasmic sperm injection (ICSI) treatment is the fertility potential of women which is dependent on the quantity and the quality of the ovarian reserve (OR) [1].The first indicator of the OR taken into consideration is the age of women. One of the prerequisites for women undergoing intracytoplasmic sperm injection (ICSI) treatment is the fertility potential of women which is dependent on the quantity and the quality of the ovarian reserve (OR) [1]. Prediction of ovarian response is one of the prerequisites for women undergoing intracytoplasmic sperm injection (ICSI) treatment prior to the first controlled ovarian stimulation (COS) cycle. Objective: To evaluate antral follicle count (AFC), anti-müllerian hormone (AMH) and basal follicle stimulating hormone (FSH) for predicting ovarian responses in patients under controlled ovarian hyperstimulation randomized to receive either oral contraceptives (OC) or no treatment (non-OC) prior to their first controlled ovarian stimulation (COS) cycle. Poor responders showed less number of oocytes retrieved and had lower AFC and AMH but a higher basal FSH level was recorded in both groups (OC and non-OC). Conclusion: The better predictive value of AMH or AFC, as a single test or in combination will prevent cycle cancellations due to too low or too high ovarian response
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