Early follicular anti-mullerian hormone as a predictor of ovarian response during ICSI cycles

Objective: To evaluate the use of AMH in predicting the ovarian response in ICSI cycles compared to other markers of ovarian function.Design: Prospective study.Setting: IVF/ICSI Unit; Enjab Hospital for infertility, Gulf Medical College and Research Centre (UAE) and Biochemistry department, Faculty of Pharmacy for Girls, Al-Azhar University (Egypt).Subject(s): A total of 220 infertile women attending an ART program (ICSI) for the first time during the period from June 2007 to October 2009 who met the inclusion criteria were our subjects . On day-3 of the menstrual cycle, serum levels of AMH, FSH, LH, E2, and inhibin B were measured for each woman. Early antral follicles were evaluated by vaginal ultrasound. Thereafter, the patients were classified according to oocyte count into two groups; Good responders (those with ⩾4 oocytes) and poor responders (those with <4 oocytes).Intervention(s): None.Main outcome measure(s): Comparison of day-3 serum AMH levels in both groups. Antral follicle count, basal FSH, LH, E2 and inhibin B were also compared.Results: The serum level of AMH, AFC and FSH levels were significantly different in both groups. Parameters such as serum LH, E2 and inhibin B levels were not significantly different between the two groups. Ovarian response was significantly correlated with basal AMH levels, FSH levels and AFC. However, AMH levels were highly correlated with the number of retrieved oocytes (P<0.001) than did AFC (P<0.01) or FSH (P<0.05) on day-3 of the cycle. Day-3 AMH was more sensitive and specific with higher predictivity for ovarian response than either day-3 AFC or day-3 FSH.Conclusion: Serum AMH levels may reflect ovarian response better than the usual hormone markers