Prediction of the number of oocytes based on AMH and FSH levels in IVF candidates

Yıl 2020, , 733 - 737, 01.09.2020

Nur Dokuzeylül Güngör , Tuğba Gürbüz

https://doi.org/10.28982/josam.759207

Cited By: 1

Öz

Aim: The purpose of this study was to predict the number of oocytes using anti-Mullerian hormone (AMH) and Follicle Stimulating Hormone (FSH) levels in In Vitro Fertilization (IVF) candidates.
Methods: This retrospective cohort study included 121 (23 cases with poor response, 92 cases with normal response, and 6 cases with excessive response) infertile patients. We examined the relationship between AMH and FSH levels and the number of oocytes. The method used in this study was to consider the number of oocytes as the response variable and identify the effective factors. All analyses were performed with free R software.
Results: The results show that although the ovarian response is associated with serum AMH levels and the women's age (P=0.04 and P<0.001, respectively), the negative linear and binomial regression yield a significant collinearity and the natural logarithm of AMH alone can be a good estimate of the ovarian response (P<0.001). ROC curves in logistic regression were used to determine cutoff points. The results of this regression showed that the natural logarithm of AMH with a cutoff value of 1.36 ng/ml can determine the line between the poor and normal ovarian response (P<0.01). The natural logarithm of AMH cannot determine the cutoff value of normal and excessive ovarian response (P>0.05).
Conclusion: The use of serum AMH levels is important for the prediction of poor ovarian response.

Anahtar Kelimeler

Anti-Mullerian Hormone, Ovarian Response, Oocytes

IVF adaylarında AMH ve FSH seviyelerine göre oosit sayısının tahmini

Öz

Amaç: Bu çalışmanın amacı IVF tedavisi planlanan olgularda serum AMH ve FSH düzeylerini kullanarak oosit sayısını tahmin etmektir.
Yöntemler: Bu retrospektif kohort çalışma 121 infertil hastayı (düşük over rezervi (n=23), normal over rezervi (n=92) ve yüksek over rezervi (n=6)) kapsamaktadır. Çalışmada AMH, FSH ve oosit sayıları arasındaki ilişki değerlendirilmiştir. Oosit sayısı değişken yanıt olarak kabul edilip etkileyen faktörler tanımlanmıştır. Tüm analizler ücretsiz R software ile yapılmıştır.
Bulgular: Sonuçlar, over cevabının serum AMH seviyeleri ve ayrıca kadınların yaşı (sırasıyla P=0,04 ve P<0,001) ile ilişkili olmasına rağmen, negatif doğrusal ve binom regresyonunun, anlamlı bir eşdoğrusallık ve tek başına AMH'nin doğal logaritmasının olduğunu gösterdiğini göstermektedir ve over cevabı için iyi bir tahmini olabilir (P<0,001). Kesim noktalarını belirlemek için lojistik regresyondaki ROC eğrileri kullanılmıştır. Bu regresyonun sonuçları, 1,36 ng/ml'lik bir kesme değerine sahip doğal AMH logaritmasının, zayıf ve normal yumurtalık tepkisi arasındaki sınırı belirleyebileceğini gösterdi (P<0,01). AMH'nin doğal logaritması, normal ve aşırı over cevabının kesim değerini belirleyemez (P>0,05).
Sonuç: AMH özellikle düşük over rezervinin tahmininde predikte edici önemli bir faktördür.

Anahtar Kelimeler

Anti-Mülleryan Hormon, Over Cevabı, Oosit

Destekleyen Kurum

yok

Kaynakça

• 1. Sonaliya KN. Infertility: Ongoing Global challenge of new millennium. Indian Journal of Community Health. 2016;28(2):113-5.
• 2. Bell AV. Beyond (financial) accessibility: inequalities within the medicalisation of infertility. Sociology of health & illness. 2010;32(4):631-46.
• 3. Petraglia F, Serour GI, Chapron C. The changing prevalence of infertility. International Journal of Gynecology & Obstetrics. 2013;123:4-8.
• 4. Vander Borght M, Wyns C. Fertility and infertility: Definition and epidemiology. Clinical biochemistry. 2018;62:2-10.
• 5. Barbieri RL. Female infertility. Yen and Jaffe's Reproductive Endocrinology: Elsevier; 2019;7:556-81.
• 6. Elder K, Dale B. In-vitro fertilization: Cambridge University Press; 2000;1-30.
• 7. Ubaldi F, Vaiarelli A, D’Anna R, Rienzi L. Management of poor responders in IVF: is there anything new? BioMed research international. 2014;20:146.
• 8. Jirge PR, Chougule SM, Gavali VG, Bhomkar DA. Impact of dehydroepiandrosterone on clinical outcome in poor responders: a pilot study in women undergoing in vitro fertilization, using bologna criteria. Journal of human reproductive sciences. 2014;7(3):175.
• 9. Balaban B, Urman B. Effect of oocyte morphology on embryo development and implantation. Reproductive biomedicine online. 2006;12(5):608-15.
• 10. Templeton A, Morris JK. Reducing the risk of multiple births by transfer of two embryos after in vitro fertilization. New England Journal of Medicine. 1998;339(9):573-7.
• 11. Russell JB, Knezevich KM, Fabian KF, Dickson JA. Unstimulated immature oocyte retrieval: early versus midfollicular endometrial priming. Fertility and sterility. 1997;67(4):616-20.
• 12. Matter H, Talansky B, Gordon J, Cohen J. Monospermy and polyspermy after partial zona dissection of reinseminated human oocytes. Gamete research. 1989;23(4):377-86.
• 13. Nakahara K, Saito H, Saito T, Ito M, Ohta N, Sakai N, et al. Incidence of apoptotic bodies in membrana granulosa of the patients participating in an in vitro fertilization program. Fertility and sterility. 1997;67(2):302-8.
• 14. Chen Q, Wang Y, Sun L, Zhang S, Chai W, Hong Q, et al. Controlled ovulation of the dominant follicle using progestin in minimal stimulation in poor responders. Reproductive Biology and Endocrinology. 2017;15(1):71.
• 15. Ben-Ze'ev A, Amsterdam A. Regulation of cytoskeletal proteins involved in cell contact formation during differentiation of granulosa cells on extracellular matrix. Proceedings of the National Academy of Sciences. 1986;83(9):2894-8.
• 16. Chang M-Y, Chiang C-H, T’sang-T’ang Hsieh M, Soong Y-K, Hsu K-H. Use of the antral follicle count to predict the outcome of assisted reproductive technologies. Fertility and Sterility. 1998;69(3):505-10.
• 17. Yassin MM, Sharif FA, Laqqan MM. Anti-mullerian hormone as a predictor of ovarian reserve and ovarian response in IVF women from Gaza strip. Iranian Journal of reproductive medicine. 2013;11(4):261.
• 18. Lin P-Y, Huang F-J, Kung F-T, Chiang H-J, Lin Y-J, Lin Y-C, et al. Evaluation of serum anti-Mullerian hormone as a biomarker of early ovarian aging in young women undergoing IVF/ICSI cycle. International journal of clinical and experimental pathology. 2014;7(9):6245.
• 19. Chang HJ, Han SH, Lee JR, Jee BC, Lee BI, Suh CS, et al. Impact of laparoscopic cystectomy on ovarian reserve: serial changes of serum anti-Müllerian hormone levels. Fertility and sterility. 2010;94(1):343-9.
• 20. Singh N, Malik E, Banerjee A, Chosdol K, Sreenivas V, Mittal S. “Anti-Mullerian Hormone: Marker for Ovarian Response in Controlled Ovarian Stimulation for IVF Patients”: A First Pilot Study in the Indian Population. The Journal of Obstetrics and Gynecology of India. 2013;63(4):268-72.
• 21. Li HWR, Wong CYG, Yeung WSB, Ho PC, Ng EHY. Serum anti-müllerian hormone level is not altered in women using hormonal contraceptives. Contraception. 2011;83(6):582-5.
• 22. Scott RT, Toner JP, Muasher SJ, Oehninger S, Robinson S, Rosenwaks Z. Follicle-stimulating hormone levels on cycle day 3 are predictive of in vitro fertilization outcome. Fertility and sterility. 1989;51(4):651-4.
• 23. Muasher SJ. Treatment of low responders. Journal of assisted reproduction and genetics. 1993;10(2):112-4.
• 24. Xiao-dong M, Yi Z, Ya-jun C, Kang-sheng L. Detection of Serum Anti-Müllerian Hormone Level for Women of Reproductive Age: A Cross-Sectional Study. Journal of International Translational Medicine. 2017;5(2):67-70.
• 25. Kucuk T, Kozinoglu H, Kaba A. Growth hormone co-treatment within a GnRH agonist long protocol in patients with poor ovarian response: a prospective, randomized, clinical trial. Journal of assisted reproduction and genetics. 2008;25(4):123-7.
• 26. Heidar Z, Bakhtiyari M, Mirzamoradi M, Zadehmodarres S, Sarfjoo F, Mansournia M. Prediction of different ovarian responses using anti-Müllerian hormone following a long agonist treatment protocol for IVF. Journal of endocrinological investigation. 2015;38(9):1007-15.
• 27. Aydın GA, Yavuz A, Terzi H, Kutlu T. Assessment of the relationship of basal serum anti-mullerian hormone levels with oocyte quality and pregnancy outcomes in patients undergoing ICSI. Iranian Journal of reproductive medicine. 2015;13(4):231.
• 28. Erfanian Ahmadpoor M, Saraf Razavi M, Afsharnejad S, Mansouri Torshizi M. Studying the FSH and LH Hormones in The Cycle Third Day and Its Effect On the Number and Quality of Oocytes Among the Infertile Women as Candidate for Assisted Reproductive Technology Cycle. Mashhad Journal of Medical Sciences. 2009;5;1-17.
• 29. Buyuk E, Seifer DB, Younger J, Grazi RV, Lieman H. Random anti-Müllerian hormone (AMH) is a predictor of ovarian response in women with elevated baseline early follicular follicle-stimulating hormone levels. Fertility and sterility. 2011;95(7):2369-72.
• 30. Ligon S, Lustik M, Levy G, Pier B. Low antimüllerian hormone (AMH) is associated with decreased live birth after in vitro fertilization when follicle-stimulating hormone and AMH are discordant. Fertility and sterility. 2019;112(1):73-81.