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Hum. Reprod. Advance Access published online on August 19, 2005
Human Reproduction, doi:10.1093/humrep/dei203
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© The Author 2005. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved.
Received April 8, 2005
Revised June 6, 2005
Accepted June 14, 2005

Article

Dynamic assays of inhibin B, anti-Mullerian hormone and estradiol following FSH stimulation and ovarian ultrasonography as predictors of IVF outcome

Talia Eldar-Geva 1*, Avraham Ben-Chetrit 2, Irving M.Spitz 3, Ron Rabinowitz 4, Einat Markowitz 2, Tzvia Mimoni 2, Michael Gal 2, Edit Zylber-Haran 2, and Ehud J. Margalioth 2

1 IVF Unit, Department of Obstetrics and Gynecology, Shaare-Zedek Medical Center, Ben Gurion University of the Negev, Jerusalem 91031, Israel; Institute of Hormone Research, Department of Obstetrics and Gynecology, Shaare-Zedek Medical Center, Ben Gurion University of the Negev, Jerusalem 91031, Israel
2 IVF Unit, Department of Obstetrics and Gynecology, Shaare-Zedek Medical Center, Ben Gurion University of the Negev, Jerusalem 91031, Israel
3 Institute of Hormone Research, Department of Obstetrics and Gynecology, Shaare-Zedek Medical Center, Ben Gurion University of the Negev, Jerusalem 91031, Israel
4 Ultrasound Unit, Department of Obstetrics and Gynecology, Shaare-Zedek Medical Center, Ben Gurion University of the Negev, Jerusalem 91031, Israel

* To whom correspondence should be addressed.
Talia Eldar-Geva, E-mail: gevat{at}szmc.org.il


  Abstract

BACKGROUND: We evaluated basal and dynamic hormonal markers [(FSH, inhibin B, estradiol and anti-Mullerian hormone (AMH)] during the follicular phase and luteal phase of the menstrual cycle and ultrasonic ovarian morphology as predictors of IVF outcome. METHODS: Fifty-six women, aged <38 years, with normal day 3 FSH levels were included prospectively. Serum estradiol, inhibin B and AMH were measured before and 24 h after administration of 300 IU of recombinant FSH on cycle day 3-4 and during the luteal phase. Ovarian volume and antral follicle count (AFC) were evaluated on cycle day 3-4. The predictive value of oocyte number and pregnancy were assessed using uni- and multivariate analysis. RESULTS:Poor responders (<6 oocytes) had significantly lower luteal AMH levels, while high responders (>20 oocytes) had significantly higher AFC, AMH and luteal stimulated inhibin B and estradiol than normal responders. Multivariate regression analyses showed that the best models for predicting oocyte number included AFC, follicular phase AMH and stimulated inhibin B. Only AMH showed a significant difference between pregnant and non-pregnant women at both cycle phases. CONCLUSIONS: In young women (<38 years), AFC or basal AMH and stimulated inhibin B predict ovarian response for IVF. The only predictor for pregnancy is follicular or luteal phase AMH.

Keywords: anti-Mullerian hormone/antral follicle count/dynamic assay/inhibin B/IVF outcome.
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