Predictive value of anti-müllerian hormone, follicle-stimulating hormone and antral follicle count on the outcome of ovarian stimulation in women following GnRH-antagonist protocol for IVF/ET

Abstract

To compare the efficacy of three methods: the levels of anti-müllerian hormone (AMH), the levels of follicle stimulating hormone (FSH) and the antral follicle count (AFC), for the prediction of the number of retrieved mature oocytes and the number of generated embryos by intracytoplasmic sperm injection (ICSI) in women stimulated with a GnRH-antagonist protocol. 105 women were enrolled in the study. At the day 2 of a preceding cycle, AFC was performed and FSH and AMH were measured in serum by immunoenzymatic assays. All women were stimulated with a GnRH-antagonist protocol and ovulation was induced with human chorionic gonadotropin. ICSI was performed in all retrieved mature oocytes. Embryo transfers were performed at days 2-3. According to the oocytes retrieved, patients were categorized as poor (<4), normal (4-12) or high responders (>12). AFC and the levels of baseline FSH and AMH were significantly different among poor, normal and high responders. The number of oocytes as well as the number of embryos was negatively correlated with baseline FSH and positively correlated with baseline AMH and AFC, whereas AFC showed the strongest correlation. Stepwise regression analysis indicated AFC and baseline AMH as the most significant parameters for the prediction of the number of oocytes; for the prediction of the number of embryos, the most significant parameter was AFC. AFC, baseline AMH and baseline FSH are good predictors for the outcome of ovarian stimulation in GnRH-antagonist cycles. However, AFC appears to have the best predictive value.