Optimal cutoff value of basal anti-mullerian hormone in iranian infertile women for prediction of ovarian hyper-stimulation syndrome and poor response to stimulation.

MedStar author(s):
Citation: Reproductive Health. 12:85, 2015.PMID: 26357853Institution: MedStar Washington Hospital CenterDepartment: Obstetrics and GynecologyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Anti-Mullerian Hormone/bl [Blood] | *Ovarian Hyperstimulation Syndrome/di [Diagnosis] | *Ovary/de [Drug Effects] | *Ovulation Induction | Female | Humans | Iran | Logistic Models | Ovarian Hyperstimulation Syndrome/ep [Epidemiology] | Prevalence | Reference ValuesYear: 2015Local holdings: Available online through MWHC library: 2004 - presentISSN:
  • 1742-4755
Name of journal: Reproductive healthAbstract: AIM: We intended to establish the threshold of Anti-Mullerian Hormone (AMH) for detection of Ovarian Hyper-Stimulation Syndrome (OHSS) and poor response to treatment in Iranian infertile women.CONCLUSIONS: Iranian women with basal AMH level>6.95 ng/ml are at high risk of developing OHSS and those with AMH level<1.65 ng/ml are poor responders.METHODS: Pre-stimulation menstrual cycle day-3 hormonal indices including basal AMH values were measured in 105 infertile women aged 32.5+/-4.3 years. Patients underwent long GnRH agonist Controlled Ovarian Hyperstimulation (COH) in a referral infertility center (Tehran, Iran). The gonadotropin dose was determined based on the age and basal serum Follicular Stimulating Hormone (FSH) level. The IVF/ICSI cycles were followed and the clinical and sonographic data were recorded.RESULTS: Sixteen cases developed OHSS. The prevalence of PCOS was higher in subjects with OHSS [62.5 % (38.8-86.2) vs. 17 % (9.2-24.9)]. The patients with OHSS had higher ovarian follicular count [23.7 (3.2) vs. 9.1 (0.5); p<0.05], collected oocytes [13.5 (1.9) vs. 6.9 (0.5); p<0.05] and AMH level [7.9 (0.7) vs. 3.6 (0.3); p<0.05]. Basal AMH level and oocyte yields (but not age, BMI, and PCOS) correlated with occurrence of OHSS; and only the AMH levels were associated with poor ovarian response (oocytes yield<4). The optimal cutoff value for the prediction of OHSS was 6.95 ng/ml (area under the receiver operating characteristics curve: 0.86; CI: 0.78-0.95; sensitivity: 75 %; specificity: 84 %; odds ratio for occurrence of OHSS: 9 and p<0.001). The optimal cut point to discriminate poor response (oocytes <4) was 1.65 ng/ml ( AUC : 0.8; CI: 0.69-0.91; sensitivity: 89 % specificity : 71 %; and OR=23.8 and P value <0.001).All authors: Abbasi M, Aghssa MM, Bagheri M, Ezzati M, Mahdavi S, Panahi Z, Tarafdari AM, Tehraninejad ESFiscal year: FY2016Digital Object Identifier: Date added to catalog: 2016-05-24
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 26357853 Available 26357853

Available online through MWHC library: 2004 - present

AIM: We intended to establish the threshold of Anti-Mullerian Hormone (AMH) for detection of Ovarian Hyper-Stimulation Syndrome (OHSS) and poor response to treatment in Iranian infertile women.

CONCLUSIONS: Iranian women with basal AMH level>6.95 ng/ml are at high risk of developing OHSS and those with AMH level<1.65 ng/ml are poor responders.

METHODS: Pre-stimulation menstrual cycle day-3 hormonal indices including basal AMH values were measured in 105 infertile women aged 32.5+/-4.3 years. Patients underwent long GnRH agonist Controlled Ovarian Hyperstimulation (COH) in a referral infertility center (Tehran, Iran). The gonadotropin dose was determined based on the age and basal serum Follicular Stimulating Hormone (FSH) level. The IVF/ICSI cycles were followed and the clinical and sonographic data were recorded.

RESULTS: Sixteen cases developed OHSS. The prevalence of PCOS was higher in subjects with OHSS [62.5 % (38.8-86.2) vs. 17 % (9.2-24.9)]. The patients with OHSS had higher ovarian follicular count [23.7 (3.2) vs. 9.1 (0.5); p<0.05], collected oocytes [13.5 (1.9) vs. 6.9 (0.5); p<0.05] and AMH level [7.9 (0.7) vs. 3.6 (0.3); p<0.05]. Basal AMH level and oocyte yields (but not age, BMI, and PCOS) correlated with occurrence of OHSS; and only the AMH levels were associated with poor ovarian response (oocytes yield<4). The optimal cutoff value for the prediction of OHSS was 6.95 ng/ml (area under the receiver operating characteristics curve: 0.86; CI: 0.78-0.95; sensitivity: 75 %; specificity: 84 %; odds ratio for occurrence of OHSS: 9 and p<0.001). The optimal cut point to discriminate poor response (oocytes <4) was 1.65 ng/ml ( AUC : 0.8; CI: 0.69-0.91; sensitivity: 89 % specificity : 71 %; and OR=23.8 and P value <0.001).

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