Serum anti-Müllerian hormone and antral follicle count as predictive markers of OHSS in ART cycles.

Abstract

OBJECTIVE:

To evaluate predictive role of day-3 serum anti-Müllerian hormone (AMH) levels and antral follicle count (AFC) in ovarian hyperstimulation syndrome (OHSS) in patients undergoing IVF/ICSI cycles.

MATERIALS AND METHODS:

Forty-one women with moderate/severe OHSS and 41 age matched women without OHSS were compared to evaluate the predictive value of certain risk factors for OHSS. AFC, and E(2), FSH, LH, AMH, inhibin-B levels measured on day 3 of the menstrual cycle before controlled ovarian hyperstimulation.

RESULTS:

Mean FSH was significantly lower (p < 0.0001); and mean LH, AFC and AMH were significantly higher in women with OHSS compared to women without OHSS (p = 0.049, p < 0.0001 and p < 0.0001, respectively). There was no significant difference in inhibin B (p = 0.112) and estradiol (p = 0.706) between the groups. The ROC area under curve (AUC) for AMH presented the largest AUC among the listed risk factors. AMH (AUC = 0.87) and AFC (AUC = 0.74) had moderate accuracy for predicting OHSS while Inhibin B (AUC = 0.58) and LH (AUC = 0.61) had low accuracy. The cut-off value for AMH 3.3 ng/mL provided the highest sensitivity (90%) and specificity (71%) for predicting OHSS. It's positive (PPV) and negative predictive values (NPV) were 61% and 94%, respectively. The cut-off value for AFC was 8 with 78% sensitivity, 65% specificity, 52% PPV and 86% NPV.

CONCLUSION:

Measurement of basal serum AMH and AFC can be used to determine the women with high risk for OHSS.

• Authors: Pelin Ocal, Sezai Sahmay, Meral Cetin, Tulay Irez, Onur Guralp, Ismail Cepni
• Journal: Journal of assisted reproduction and genetics (J Assist Reprod Genet) Vol. 28 Issue 12 Pg. 1197-203 (Dec 2011) ISSN: 1573-7330 [Electronic] Netherlands
• PMID: 21882017 (Publication Type: Journal Article)

Chemical References

• Biomarkers
• inhibin B
• Inhibins
• Anti-Mullerian Hormone
• Follicle Stimulating Hormone

Topics

• Adult
• Anti-Mullerian Hormone (blood)
• Biomarkers (blood)
• Cell Count
• Female
• Fertilization in Vitro
• Follicle Stimulating Hormone (blood)
• Humans
• Inhibins (blood)
• Middle Aged
• Ovarian Follicle (pathology, physiology)
• Ovarian Hyperstimulation Syndrome (metabolism, pathology)
• Reproductive Techniques, Assisted