Is assessment of anti-mullerian hormone and/or antral follicle count useful in the prediction of ovarian response in expected normal responders treated with a fixed dose of recombinant FSH and GnRH antagonists? A prospective observational study

Abstract

The purpose of this prospective observational study was to evaluate whether the assessment of AMH and AFC is useful in the prediction of ovarian response in expected normal responders treated with a fixed dose of recombinant FSH (rec-FSH) and GnRH antagonists. A base model including age and basal FSH as independent predictors of COCs could explain 15% of the variance observed in the number of COCs retrieved (p = 0.002). The addition of AFC did not increase significantly the predictive ability of the above model, whereas the addition of AMH increased the performance of the base model by 13% (p < 0.001). Logistic regression analysis showed that only when AMH was added to the base model, including age and FSH, its predictive capacity for high ovarian response was statistically significant (F-test: p = 0.001; c-statistic: 0.80, 95% CI: 0.70–0.88), but this was not the case for poor ovarian response. In conclusion, the addition of AMH, but not of AFC, to a model including female age and basal FSH, is useful in the prediction of ovarian response in expected normal responders treated with a fixed dose of recombinant FSH and GnRH antagonists.

Chinese abstract

这项前瞻性观察性研究的目的在于评估用抗苗勒氏管激素和/或窦卵泡计数对用固定剂量重组FSH和GnRH拮抗剂预计正常反应的患者，预测卵巢反应是否有用。基础模型中包含年龄和基础FSH值作为卵母细胞发育独立预测因子能够解释获卵数量差异的15%原因，增加AFC并不能显著增加上述模型的预测能力，但是增加AMH能增加13%的预测能力。Logistic回归分析显示在包含年龄和FSH的基础模型中仅增加AMH，它对卵巢高反应的的预测能力在统计学上是有显著意义的（F检验：p =.001；c-tatistic: 0.80, 95% CI: 0.70–0.88)，但是对卵巢低反应的预测能力统计学上无显著性。结论是，在包含女性年龄和基础FSH值的模型中，增加AMH而不是AFC，是可以用于预测应用固定剂量的重组FSH和GnRH拮抗剂治疗的IVF患者卵巢的反应情况。

• AMH
• antral follicle count
• GnRH antagonists
• ovarian reserve markers
• ovarian response.

Acknowledgements

MAG has contributed substantially in the collection, analysis and interpretation of the data and drafted the manuscript. EMK conceived the idea of the study, and contributed substantially in the collection, analysis and interpretation of the data and revised the manuscript for important intellectual content. CAV contributed substantially in the analysis and interpretation of the data and revised the manuscript for important intellectual content. SG, GAM, and NK contributed substantially in the collection and interpretation of the data and revised the manuscript for important intellectual content. BCT conceived the idea of the study, and contributed substantially in the collection, analysis and interpretation of the data and revised the manuscript for important intellectual content. All authors have read and approved the final version of the manuscript.