Skip to main content
Log in

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

  • Gynecologic Endocrinology and Reproductive Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Aim

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.

Materials and methods

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).

Results

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.

Conclusions

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Kolibianakis EM, Griesinger G, Tarlatzis BC (2012) GnRH-antagonists in ovarian stimulation for IVF. In: Gardner DK, Weissman A, howles CM, Shoham Z (eds) Textbook for Assisted Reproductive Techniques, 4th edn, vol 2, clinical perspectives. Informa healthcare, pp 124–131

  2. Johnson J, Canning J, Kaneko T, Pu JK, Tilly JL (2004) Germline stem cells and follicular renewal in the postnatal mammalian ovary. Nature 428(6979):145–150

    Article  CAS  PubMed  Google Scholar 

  3. Fauser BC, Diedrich K, Devroey P, Evian Annual Reproduction Workshop Group 2007 (2008) Predictors of ovarian response: progress towards individualized treatment in ovulation induction and ovarian stimulation. Hum Reprod Update 14(1):1–14

    Article  CAS  PubMed  Google Scholar 

  4. Tsepelidis S, Devreker F, Demeestere I, Flahaut A, Gervy Ch, Englert Y (2007) Stable serum levels of anti-Müllerian hormone during the menstrual cycle: a prospective study in normo-ovulatory women. Hum Reprod 22:1837–1840

    Article  CAS  PubMed  Google Scholar 

  5. Baczkowski T, Kurzawa R, Glabowski W (2004) Methods of embryo scoring in in vitro fertilization. Reprod Biol 4(1):5–22

    PubMed  Google Scholar 

  6. Penarrubia J, Fábeques F, Manau D, Creus M, Casals G, Casamitjana R et al (2005) Basal and stimulation day 5 anti-mullerian hormone serum concentrations as predictors of ovarian response and pregnancy in assisted reproductive technology cycles stimulated with gonadotropin-releasing hormone agonist—gonadotropin treatment. Hum Reprod 20(4):915–922

    Article  CAS  PubMed  Google Scholar 

  7. Van Rooij IA, Broekmans FJ, te Velde ER, Fauser BC, Bancsi LF, Jong FH et al (2002) Serum anti-mullerian hormone levels: a novel measure of ovarian reserve. Hum Reprod 17:3065–3071

    Article  PubMed  Google Scholar 

  8. Muttukrishna S, McGarrigle H, Wakim R, Khadum I, Ranieri DM, Serhal P (2005) Antral follicle count, anti-mullerian hormone and inhibin B: predictors of ovarian response in assisted reproductive technology? BJOG 112:1384–1390

    Article  CAS  PubMed  Google Scholar 

  9. Elgindy EA, El-Haieg DO, El-Sebaey A (2008) Anti-mullerian hormone: correlation of early follicular, ovulatory and midluteal levels with ovarian response and cycle outcome in intracytoplasmic sperm injection patients. Fertil Steril 89:1670–1676

    Article  CAS  PubMed  Google Scholar 

  10. Lekamge DN, Barry M, Kolo M, Lane M, Gilchrist RB, Tremellen KP (2007) Anti-mullerian hormone as a predictor of IVF outcome. Reprod Biomed Online 14:602–610

    Article  CAS  PubMed  Google Scholar 

  11. Broer SL, Mol BW, Hendriks D, Broekmans FJ (2009) The role of antimullerian hormone in prediction of outcome after IVF: comparison with the antral follicle count. Fertil Steril 91(3):705–714

    Article  CAS  PubMed  Google Scholar 

  12. Jayaprakasan K, Campbell B, Hopkisson J, Johnson I, Raine-Fenning N (2010) A prospective, comparative analysis of anti-Mullerian hormone, inhibin-B, and three-dimensional ultrasound determinants of ovarian reserve in the prediction of poor response to controlled ovarian stimulation. Fertil Steril 93(3):855–864

    Article  CAS  PubMed  Google Scholar 

  13. Broer SL, Dolleman M, Opmeer BC, Fauser BC, Mol BW, Broekmans FJ (2011) AMH and AFC as predictors of excessive response in controlled ovarian hyperstimulation: a meta-analysis. Hum Reprod Update 17(1):46–54

    Article  CAS  PubMed  Google Scholar 

  14. Broer SL, van Disseldorp J, Broeze KA, Dolleman M, Opmeer BC, Bossuyt P et al (2013) Added value of ovarian reserve testing on patient characteristics in the prediction of ovarian response and ongoing pregnancy: an individual patient data approach. Hum Reprod Update 19(1):26–36

    Article  PubMed  Google Scholar 

  15. Eldar-Geva T, Ben-Chetrit A, Spitz IM, Rabinowitz R, Markowitz E, Mimoni T et al (2005) Dynamic assays of inhibin B, anti-mullerian hormone and estradiol following FSH stimulation and ovarian ultrasonography as predictors of IVF outcome. Hum Reprod 20:3178–3183

    Article  CAS  PubMed  Google Scholar 

  16. Kwee J, Schats R, McDonnell J, Themmen A, de Jong F, Lambalk C (2008) Evaluation of anti-müllerian hormone as a test for the prediction of ovarian reserve. Fertil Steril 90:737–743

    Article  CAS  PubMed  Google Scholar 

  17. Fanchin R, Mendez Lozano DH, Frydman N, Gougeon A, di Clemente N, Frydman R et al (2007) Anti-müllerian hormone concentrations in the follicular fluid of the preovulatory follicle are predictive of the implantation potential of the ensuing embryo obtained by in vitro fertilization. J Clin Endocrinol Metab 92(5):1796–1802

    Article  CAS  PubMed  Google Scholar 

Download references

Conflict of interest

All authors declare that they have participated to this study and approved the final version submitted to your journal. Also all authors declare that there is no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Angelos Daniilidis.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tsakos, E., Tolikas, A., Daniilidis, A. et al. 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. Arch Gynecol Obstet 290, 1249–1253 (2014). https://doi.org/10.1007/s00404-014-3332-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-014-3332-3

Keywords

Navigation