A prospective, comparative analysis of anti-Müllerian hormone, inhibin-B, and three-dimensional ultrasound determinants of ovarian reserve in the prediction of poor response to controlled ovarian stimulation  

Oleh:

Jayaprakasan, Kannamannadiar ; Campbell, Bruce ; Hopkisson, James ; Johnson, Ian ; Raine-Fenning, Nick

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Fertility and Sterility (keterangan: ada di ClinicalKey) vol. 93 no. 03 (Feb. 2010), page 855-864.
Topik: In vitro fertilization; three-dimensional (3D) ultrasound; ovarian reserve; antral follicle count; anti-Müllerian hormone

Ketersediaan

Perpustakaan FK Nomor Panggil: F02.K.2010.01 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

Lihat Detail Induk

Isi artikel

Objective To compare three-dimensional ultrasound parameters, antral follicle count (AFC), ovarian volume, and ovarian vascularity indices with anti-Müllerian hormone (AMH) and other conventional endocrine markers for the prediction of poor response to controlled ovarian hyperstimulation (COH) during assisted reproduction treatment (ART). Design Prospective study. Setting University-based assisted conception unit. Patient(s) One hundred thirty-five women undergoing the first cycle of ART. Intervention(s) Transvaginal three-dimensional ultrasound assessment and venipuncture in the early follicular phase of the menstrual cycle immediately before ART. Main Outcome Measure(s) Poor ovarian response and nonconception. Result(s) Antral follicle count (Exp(B): 0.65) and AMH (Exp(B): 0.13) were the most significant predictors of poor ovarian response on multiple regression analysis and their predictive accuracy was similar, with an area under the curve (AUC) of 0.935 and 0.905, respectively. The AFC and AMH, as a combined test, did not significantly improve the level of prediction (AUC = 0.946). The sensitivity and specificity for prediction of poor ovarian response were 93% and 88% for AFC and 100% and 73% for AMH at an optimum cutoff values of =10 and =0.99 ng/mL, respectively. Age (Exp(B): 1.191) was the only significant predictor of nonconception, although its predictive accuracy was also low (AUC = 0.674). Conclusion(s) The AFC and AMH are the most significant predictors of poor response to ovarian stimulation during ART. The AMH and AFC, either alone or in combination, demonstrate a similar predictive power but are not predictive of nonconception, which is dependent on the woman's age.

Opini Anda

Klik untuk menuliskan opini Anda tentang koleksi ini!

Kembali