PREDICTIVE VALUE OF ANTI MULLERIAN HORMONE LEVEL IN SERUM AND FOLLICULAR FLUID FOR OVARIAN RESPONSE IN WOMEN UNDERGOING OVARIAN STIMULATION FOR IN VITRO FERTILIZATION
*Mofed Fawzi MD, Prof. Yehia A. Wafa and Ahmed Marzouk Morad
ABSTRACT
Objective: to evaluate the predictive value of follicular and serum AMH for extremes of ovarian response in women undergoing controlled ovarian hyperstimulation. Design: Prospective cohort study. Setting: Tertiary referral center for reproductive medicine at the IVF unit of EL-Hussin Hospital and EL-Galaa Maternity Teaching Hospital which are two referral hospitals located in cairo governorate, the Egyptian capital, between October and December 2016. Patient(s): 50 women undergone their cycles of controlled ovarian hyperstimulation for in vitro fertilization (IVF). Materials and Methods: Basal serum level of AMH and follicular fluid AMH(Anti mullerian hormone) measured in 50 patients. All patients were followed prospectively and their cycle outcomes recorded. Main Outcome Measure(s): the predictive value of follicular and serum AMH for extremes of ovarian response of stimulation. Result(s): out of 50 cycles in 50 women according to inclusion criteria, total 33 pregnancies were acheived (clinical pregnancy rate 66.0% confirmed 4 weeks later from day of retreival by U/S). Further, significantly higher levels of FF AMH in conception (n = 33) cycles compared to nonconception (n=17) cycles (mean 53.14 vs. 16.84 ng/ml; P < 0.001). Also, fertilization rate with both serum &FF indcated an extremely significant difference when (P<0.001). Since there was an extremely significant difference in serum AMH levels between conception and nonconception cycles (mean 3.05 vs 1.14 ng/ml, P < 0.001).they were subsequently presented data about the relation between high level of AMH in serum and FF and The N. of embryos transferred in all 50 cycles., there is an invers relation between AMH serum and FF and age of female and BMI. Finally, a direct propotional between levels of serum and FF AMH shows highly statistically significant deference between AMH serum and AMH FF when p-value was <0.001*. Conclusion(s): Serum AMH levels can predict ovarian response during first IVF treatment cycles.AMH in the pooled FF and serum can be used as a potent biochemical indicator as a predictive value for success in conventional IVF cycles, FF AMH levels acts as an index of oocyte maturity and therefore it's quality.
Keywords: Antral follicle count, anti-M€ullerian hormone, controlled ovarian hyperstimulation, exogenous gonadotrophins, follicle stimulating hormone, ovarian response.
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