Articulo Científico Sobre Hormonas

Clin Exp Reprod Med. 2011 September; 38(3): 153–158.Published online 2011 September 30. doi:  10.5653/cerm.2011.38.3.153 | PMCID: PMC3283065 |
Copyright © 2011. The Korean Society for Reproductive MedicineSerum anti-Müllerian hormone levels as a predictor of the ovarian response and IVF outcomesMin Hye Choi, Ji Hee Yoo, Hye Ok Kim, Sun Hwa Cha, Chan Woo Park,Kwang Moon Yang, In Ok Song, MiKyoung Koong, and Inn Soo KangDivision of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea.Corresponding author.Corresponding author: Hye Ok Kim. Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Health Care Center, Kwandong UniversityCollege of Medicine, 1-19 Mukjeong-dong, Jung-gu, Seoul 100-380, Korea. Tel:             +82-2-2000-7549      , Fax: +82-2-2000-7790, Email: ok58163@hanmail.netReceived August 5, 2011; Revised September 9, 2011; Accepted September 16, 2011.This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License(http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. *  Other Sections▼AbstractObjectiveThe aim of this study was to investigate whether anti-Mullerian hormone (AMH) levels could be predict ovarian poor/hyper response and IVF cycle outcome.MethodsBetween May 2010 and January 2011, serum AMH levels wereevaluated with retrospective analysis. Three hundred seventy infertile women undergoing 461 IVF cycles between the ages of 20 and 42 were studied. We defined the poor response as the number of oocytes retrieved was equal or less than 3, and the hyper response as more than 25 oocytes retrieved. Serum AMH was measured by commercial enzyme-linked immunoassay.ResultsThe number of oocytes retrieved wasmore correlated with the serum AMH level (r=0.781, p<0.01) than serum FSH (r=-0.412, p<0.01). The cut-off value of serum AMH levels for poor response was 1.05 ng/mL (receiver operating characteristic [ROC] curves/area under the curve [AUC], ROCAUC=0.85, sensitivity 74%, specificity 87%). Hyper response cut-off value was 3.55 ng/mL (ROCAUC=0.91, sensitivity 94%, specificity 81%). When thestudy group was divided according to the serum AMH levels (low: <1.05 ng/mL, middle: 1.05 ng/mL - 3.55 ng/mL, high: >3.55 ng/mL), the groups showed no statistical differences in mature oocyte rates (71.6% vs. 76.5% vs. 74.8%) or fertilization rates (76.9% vs. 76.6% vs. 73.8%), but showed significant differences in clinical pregnancy rates (21.7% vs. 24.1% vs. 40.8%, p=0.017).ConclusionTheserum AMH level can be used to predict the number of oocytes retrieved in patients, distinguishing poor and high responders.Keywords: Anti-Müllerian Hormone, Ovarian Response, Poor Response, Hyper Reponse, In Vitro Fertilization, Human *  Other Sections▼IntroductionIn order to do appropriate controlled ovarian hyperstimulation (COH) during IVF, the evaluation of the ovarian reserve is necessary[1,2]. Assessment of the ovarian reserve via age plays an important role in evaluation, but age by itself does not accurately predict the ovarian reserve. Traditionally, there are several ovarian reserve tests, including those that test for biochemical and ultrasonographic markers. Basal FSH, E2 and inhibin B levels are used as biochemical markers. But, their values are influenced by the menstrualcycle and have limited use for predicting poor and high responders. Ultrasonographic markers, such as antral follicle count (AFC) and ovarian volumes have been shown to be affected by interobserver variation [2-5].Recently, anti-Müllerian hormone (AMH) has been evaluated as a potential novel clinical marker of ovarian reserve [6-10]. AMH is a dimeric glycoprotein belonging to the transforming...