Anti-Müllerian hormone for prediction of ovarian stimulation response in polycystic ovary syndrome

Abstract

Background: Women with polycystic ovarian syndrome (PCOS) are known to have elevated circulating Anti-Müllerian hormone (AMH), which has been found to desensitize ovarian follicles to follicle stimulating hormone (FSH). Objectives: To determine the predictive value of serum anti-müllerian hormone (AMH) concentration on ovarian response to different stimulation protocols in polycystic ovary syndrome (PCOS). Patients and Methods: A prospective comparative study was done in Obstetrics and Gynecology department, Qena Faculty of Medicine, South Valley University on 180 infertile women with PCOS attended the infertility outpatient clinic divided into three groups 60 patients each, the 1st group received clomiphene citrate, 2nd group received gonadotrophin, and the 3rd group offered Laparoscopic ovarian drilling, Ovulation and pregnancy rates were measured. Results: in patients with PCO AMH level with a cutoff value of (3.8 ng/ml), could be used to predict response to CC in obese women, AMH levels of a cutoff value of (4.95 ng/ml), could be used to predict response to Gonadotrophin in women with PCOS, And an AMH level of a cutoff value of (5.74 ng/ml), could be used to predict response to laparoscopic ovarian diathermy in PCOS, there was a statistically significant relation between AMH level and Ovulation and pregnancy rates. Conclusion: PCOS women with high serum AMH levels seem to be resistant to ovulation induction by clomiphen citrate, gonadotrophin and laparscopic ovarian drilling. Pretreatment measurement of serum AMH concentrations may therefore be a valuable predictor of success and may help in determining the starting dose.

Keywords

• anti-müllerian hormone; ovarian stimulation response; polycystic ovary syndrome