The role of FSH to AMH ratio in low prognosis patients undergoing ICSI cycle

Abstract

The objective of this study was to estimate the number of oocyte retrieval and cycle cancellation via FSH/AMH ratio in low prognosis patients undergoing ICSI treatment.This retrospective study including fresh cycles was conducted in Hospital, between January 2015 and October 2018. Women aged between 24 and 44 years were recruited and the baseline serum hormone levels, FSH/AMH ratio, and the antral follicle count were recorded. Number of retrieved oocytes, metaphase II oocytes, fertilised oocytes, and the number and grade of the embryos were also recorded.A total of 108 cycles, corresponding to 92 women with low prognosis were eligible for analysis. The use of FSH/AMH ratio performed well in predicting retrieved oocyte lesser than 5 with an AUC of 0.82 (95% CI 0.71-0.92). A cut-off value of 11.36 was set for the retrieval of less than 5 oocyte at OPU with 80% sensitivity and 87% specificity. The FSH/AMH cut-off value was 14.22 to differentiate the cycle cancellation and no oocyte retrieval at OPU, providing a sensitivity of 91%; a specificity of 44% (AUC of 0.71; 95% CI, 0.59-0.83). There was no correlation between FSH/AMH ratio and clinical pregnancy.The assessment of this simple ratio at the beginning of the cycle may help clinicians better anticipate the gonadotropin stimulation treatment and better counsel patients about the cycle cancellation and the expected oocyte.