Concentrations of ovarian proteohormones as biological markers for the outcome of assisted reproductive technology

Objective: To assess whether the ovarian proteohormones inhibin A and B, pro‐alpha‐C and activin A could act as direct biological markers of a poorer or better response to ovulation induction or clinical conception through assisted reproductive technology (ART). Methods: Seventy‐seven women who underwent ART were included in the study and were divided into two groups: (i) 46 women with sonographically documented follicular maturation; and (ii) 36 women who demonstrated inadequate follicle development. Blood samples were analyzed for inhibin A, inhibin B, pro‐alpha‐C, activin A and estradiol (E 2 ) at day 3 of stimulation with recombinant follicle‐stimulating hormone (rFSH) after pituitary downregulation. Results: Women with sonographically documented follicular maturation compared with those with inadequate follicle development showed a highly significant ( P < 0.001), more than double, increase in inhibin B. The level of pro‐alpha‐C was 1.5‐fold as high ( P = 0.007), while E 2 , at a factor of 2.1‐fold, exhibited a borderline significant increase ( P = 0.028). Activin A and inhibin A levels exhibited no change under rFSH stimulation. Conclusions: The present study showed, in a small number of patients undergoing in vitro fertilization treatment with rFSH stimulation, that inhibin B acts as a reliable marker for biochemical monitoring at day 3 of stimulation with rFSH in ART.