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Hum. Reprod. Advance Access originally published online on November 13, 2007
Human Reproduction 2008 23(1):160-167; doi:10.1093/humrep/dem254
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© The Author 2007. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Serum anti-müllerian hormone and estradiol levels as predictors of ovarian hyperstimulation syndrome in assisted reproduction technology cycles

Tsung-Hsien Lee1,2,3, Chung-Hsien Liu3, Chuin-Chia Huang4,5, Yi-Ling Wu3,4, Yang-Tse Shih3, Hong-Nerng Ho1, Yu-Shih Yang1 and Maw-Shang Lee3,4,6,7

1 Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China 2 Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China 3 Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan, Republic of China 4 Division of Infertility Clinic, Lee Women’s Hospital, 263, Pei-Tun Road, Taichung, Taiwan, Republic of China 5 Department of Biotechnology, Central Taiwan University of Science and Technology, Taichung, Taiwan, Republic of China 6 College of Medicine, Chinese Medical University, Taichung, Taiwan, Republic of China

7 Correspondence address. Fax: +886-4-22384602; E-mail: msleephd{at}giga.net.tw

BACKGROUND: Anti-Müllerian hormone (AMH) is reported to be a reliable marker of the ovarian response to controlled ovarian stimulation (COS). The objective of this study is to determine whether the serum AMH level can predict ovarian hyperstimulation syndrome (OHSS) prior to selection of COS protocols.

METHODS: A cohort of 262 IVF cycles was investigated prospectively, in order to evaluate the predictive value for OHSS by means of certain risk factors, including age, body mass index (BMI), serum estradiol (E2) level, number of retrieved oocytes and basal serum AMH level.

RESULTS: The basal serum AMH level predicted OHSS better than age and BMI with a sensitivity of 90.5% and specificity of 81.3%. Both the basal serum AMH level (odds ratio: 1.7856, P = 0.0003) and serum E2 level on the day of HCG administration (odds ratio: 1.0005, P = 0.0455) proved to be significant predictors of OHSS by logistic regression analysis. However, age (odds ratio: 0.9346, P = 0.049) was the only significant factor for prediction of clinical pregnancy.

CONCLUSIONS: The basal serum AMH level could be utilized effectively to predict OHSS and thus to direct the selection of mild COS protocols.

Key words: anti-Müllerian hormone/ovarian hyperstimulation syndrome/controlled ovarian stimulation/estradiol

Submitted on March 27, 2007; resubmitted on June 30, 2007; accepted on July 11, 2007.


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