Antimüllerian hormone in gonadotropin releasing-hormone antagonist cycles: prediction of ovarian response and cumulative treatment outcome in good-prognosis patients

Arce, Joan Carles; Marca, Antonio La; Klein, Bjarke M.; Andersen, Anders Nyboe; Fleming, Richard

doi:10.1016/j.fertnstert.2012.12.048

Cited by 158 publications

(146 citation statements)

References 28 publications

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“…OR of 0.3 can be interpreted as a 70 % reduction in low oocyte yield for each additional unit increase of AMH. This is consistent with prior studies in healthy populations demonstrating the predictive power of AMH for response to stimulation and ART outcomes [32,33]. Low AMH has been associated with poor response to stimulation and oocyte yield [34][35][36] and may also be useful information prior to starting the cycle.…”

Section: Discussionsupporting

confidence: 90%

Outcomes of ovarian stimulation after treatment with chemotherapy

Chan

Johnson

Efymow

et al. 2015

J Assist Reprod Genet

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Purpose Chemotherapeutic agents have a known gonadotoxic effect; however, it is difficult to predict the impact they may have on ovarian stimulation. The objective of this study was to evaluate response to ovarian stimulation in patients exposed to chemotherapy compared with patients who were chemotherapy-naïve. Methods A retrospective cohort study of 130 patients with cancer or autoimmune disease was performed. Demographics, ovarian reserve, ovarian response and stimulation parameters, and oocyte data were compared between patients who were pre-and post-chemotherapy. Logistic regression modeling was performed to identify risk factors for cancellation and low oocyte yield, adjusting for confounders as appropriate. Results Antral follicle count (AFC) was significantly lower in post-chemo patients (9 vs. 17, p<0.001). Post-chemotherapy patients were more likely to be cancelled during stimulation (23 vs. 4 %, p=0.003). Among those that went to retrieval, there was no difference in total number of oocytes (10 vs. 10, p=0.31) or mature oocytes retrieved (8 vs. 8, p=0.38), despite higher starting (300 vs. 450 IU, p<0.001) and total gonadotropin (3075 vs. 4612.5 IU, p=0.008) doses in post-chemotherapy patients. Low AFC (≤6) was associated with cycle cancellation (OR 7.7, 95 % CI 1.8-33.2) and low oocyte yield (<6) (OR 5.4, 95 % CI 1.6-17.7). Conclusions Patients post-chemotherapy have lower AFC compared with the chemotherapy-naïve and have higher cancellation rates. Among those who underwent oocyte retrieval, oocyte yield was similar in both groups. Low AFC was most strongly associated with cycle cancellation and oocyte yield. Post-chemotherapy patients had higher rates of cycle cancellation but did equally well as pre-chemotherapy patients if they reached retrieval.

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Section: Discussionsupporting

confidence: 90%

Outcomes of ovarian stimulation after treatment with chemotherapy

Chan

Johnson

Efymow

et al. 2015

J Assist Reprod Genet

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“…Our findings was different from other studies which had shown that AMH is the good predictor of ovarian response in GnRH antagonist cycles, but according to our results AFC was found to be a better predictor of ovarian response in patients undergoing GnRH antagonist cycle for having abnormal ovarian reserve. [15][16][17][18][19] A study done among the Vietnamese women had also shown AMH as the best predictor of ovarian response in GnRH antagonist cycle. 20 In the present study we found that the combination of biomarker particularly AFC+AMH was found to have statistical significant association in predicting the ovarian response, whereas the other biomarker combinations like AFC+FSH and AMH+FSH did not had a significant association in the ovarian response prediction.…”

Section: Discussionmentioning

confidence: 99%

“…Few of the studies done by Arce et al and TNL Vuong et al have found that FSH was significantly less useful than AFC and AMH as a predictor of ovarian response and this was almost in par with our study, where among the poor responders in our study the FSH had the lowest predictive value when compared to AFC and AMH in predicting ovarian response. 16,20 While AFC and AMH are good predictors of ovarian response, they appear to have less value in predicting live birth rate. There are number of factors that determine the chance of pregnancy other than ovarian response including embryo quality, transfer technique and endometrial receptivity, which may be why tests for ovarian response may not be sensitive enough to predict pregnancy outcome after IVF/ICSI.…”

Section: Discussionmentioning

confidence: 99%

Comparison of antral follicle count, antimullerian hormone and day 2 follicle stimulating hormone as predictor of ovarian response and clinical pregnancy rate in patient with an abnormal ovarian reserve test

Krishnakumar¹,

Agarwal²,

Nambiar³

et al. 2016

Int J Reprod Contracept Obstet Gynecol

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“…Since AFC is tied to AMH level and vice versa, a number of studies have compared AFC with AMH level as predictors of ovarian response in IVF. Three recent multicenter trials of good prognosis IVF patients showed that the AMH level was a better predictor of ovarian response than AFC in both gonadotropinreleasing hormone (GnRH) agonist and antagonist cycles [14][15][16]. In contrast, Mutlu et al (2013) conducted a prospective study which demonstrated that AFC determines p o o r o v a r i a n r e s p o n s e b e t t e r t h a n A M H [ 1 7 ] .…”

Section: Discussionmentioning

confidence: 99%

Measurement of antral follicle count in patients undergoing in vitro fertilization treatment: results of a worldwide web-based survey

Christianson

Shoham

Tobler

et al. 2015

J Assist Reprod Genet

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Purpose The purpose of the present study was to identify trends in the therapeutic approaches used to measure antral follicle count (AFC) in patients undergoing in vitro fertilization (IVF) treatment worldwide. Methods A retrospective evaluation utilizing the results of a web-based survey, IVF-Worldwide (www.IVF-Worldwide. com), was performed. Results Responses from 796 centers representing 593,200 cycles were evaluated. The majority of respondents (71.2 %) considered antral follicle count as a mandatory part of their practice with most (69.0 %) measuring AFC in the follicular phase. Most respondents (89.7 %) reported that they would modify the IVF stimulation protocol based on the AFC. There was considerable variation regarding a limit for the number of antral follicles required to initiate an IVF cycle with 46.1 % designating three antral follicles as their limit, 39.9 % selecting either four or five follicles as their limit, and 14.0 % reporting a higher cutoff criteria. With respect to antral follicle size, 61.5 % included follicles ranging between 2 and 10 mm in the AFC. When asked to identify the best predictor of ovarian hyper-response during IVF cycles, AFC was selected most frequently (49.4 %), followed by anti-Mullerian hormone level (42.7 %). Age was selected as the best predictor of ongoing pregnancy rate in 81.7 % of respondents. Conclusions While a large proportion of respondents utilized AFC as part of their daily practice and modified IVF protocol based on the measurement, the majority did not consider AFC as the best predictor of ongoing pregnancy rate.

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Antimüllerian hormone in gonadotropin releasing-hormone antagonist cycles: prediction of ovarian response and cumulative treatment outcome in good-prognosis patients

Abstract: NCT00884221.

Cited by 158 publications

References 28 publications

Outcomes of ovarian stimulation after treatment with chemotherapy

Outcomes of ovarian stimulation after treatment with chemotherapy

Comparison of antral follicle count, antimullerian hormone and day 2 follicle stimulating hormone as predictor of ovarian response and clinical pregnancy rate in patient with an abnormal ovarian reserve test

Measurement of antral follicle count in patients undergoing in vitro fertilization treatment: results of a worldwide web-based survey

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