Dynamic assays of inhibin B, anti-Mullerian hormone and estradiol following FSH stimulation and ovarian ultrasonography as predictors of IVF outcome

TLDR

The study aimed to assess whether basal and dynamic levels of FSH, inhibin B, estradiol, and AMH, together with ovarian ultrasonography, can predict IVF outcomes in women under 38 with normal day‑3 FSH. In a prospective cohort of 56 women, serum estradiol, inhibin B, and AMH were measured before and 24 h after 300 IU recombinant FSH on cycle days 3–4 and during the luteal phase, while ovarian volume and antral follicle count were recorded on days 3–4, and predictive value was evaluated with uni‑ and multivariate analyses. Multivariate analysis showed that AFC, follicular‑phase AMH, and stimulated inhibin B best predicted oocyte number, whereas only AMH at follicular and luteal phases distinguished pregnant from non‑pregnant women.

Abstract

BACKGROUND: We evaluated basal and dynamic hormonal markers [(FSH, inhibin B, estradiol and anti-Mullerian hormone (AMH)] during the follicular phase and luteal phase of the menstrual cycle and ultrasonic ovarian morphology as predictors of IVF outcome. METHODS: Fifty-six women, aged <38 years, with normal day 3 FSH levels were included prospectively. Serum estradiol, inhibin B and AMH were measured before and 24 h after administration of 300 IU of recombinant FSH on cycle day 3–4 and during the luteal phase. Ovarian volume and antral follicle count (AFC) were evaluated on cycle day 3–4. The predictive value of oocyte number and pregnancy were assessed using uni- and multivariate analysis. RESULTS:Poor responders (<6 oocytes) had significantly lower luteal AMH levels, while high responders (>20 oocytes) had significantly higher AFC, AMH and luteal stimulated inhibin B and estradiol than normal responders. Multivariate regression analyses showed that the best models for predicting oocyte number included AFC, follicular phase AMH and stimulated inhibin B. Only AMH showed a significant difference between pregnant and non-pregnant women at both cycle phases. CONCLUSIONS: In young women (<38 years), AFC or basal AMH and stimulated inhibin B predict ovarian response for IVF. The only predictor for pregnancy is follicular or luteal phase AMH.