Relations between steroids and AMH: Impact of basal and intrafollicular steroids to AMH ratios on oocyte yield and maturation rate in women with or without polycystic ovary undergoing in vitro fertilization

Abstract

Objective: This study sought to determine the relationships between serum or intrafollicular ovarian steroids and anti-mullerian hormone (AMH) and to predict impact of steroids to AMH ratios on oocyte quantity and metaphase II (MII) oocyte rate in normo-ovulatory (control) and polycystic ovary syndrome (PCOS) patients. Design. Prospective study. Setting. University hospital and research center. Patients: Thirty-two patients with PCOS and 37 controls undergoing IVF-ET. Methods: Serum (day 3) and follicular fluid (FF) from more than one follicle ≥17 mm on the day of oocyte retrieval were collected from each patients. Main Outcome Measures. Serum or follicular fluid steroids, AMH, retrieved oocytes number and maturation rate. Results: In control group, intrafollicular AMH levels were positively related to P4 and T levels (p = .002, p = .011, respectively). Multiple linear regression analysis showed serum basal AMH and T levels as independent positive predictors while T/AMH ratio and intrafollicular AMH were negative predictors for both retrieved and MII oocyte number. The presence of PCOS and intrafollicular P4/AMH ratio revealed as important negative factors influencing oocyte maturation rate. Conclusions: Serum basal T, AMH as well as their ratio and intrafollicular P4/AMH ratio may be used as predictors for retrieved oocyte number and their nuclear maturation rate, respectively.

Keywords::

• Anti mullerian hormone/AMH
• ovarian steroids to AMH ratios
• oocyte number and maturation rate
• polycystic ovary syndrome/PCOS

Acknowledgements

We thank Dr. Hojjat Zeraati from Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences for helpful advises and the personnel of Shariati University Hospital, Vali-e-Asr Reproductive Health Research and Omid IVF Centers for collecting the samples.

Declaration of Interest: Supported by a grant # 268308/k6/07 from University College of Science, University of Tehran, and financial support from KH charity foundation and university-based Vali-e-Asr reproductive health research center.