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Can highly sensitive antimüllerian hormone testing predict failed response to ovarian stimulation?
Heather R Burks1, Lauren Ross1, Neisha Opper2
1Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California.
Fertility and Sterility
|July 10, 2015
Summary
A new antimüllerian hormone (AMH) test can predict successful ovarian stimulation in women with diminished ovarian reserve (DOR). An AMH level above 500 pg/mL indicates a good chance of retrieving at least 3 oocytes for IVF.
Area of Science:
- Reproductive Endocrinology
- In Vitro Fertilization (IVF)
- Ovarian Reserve Assessment
Background:
- Diminished ovarian reserve (DOR) presents a challenge in achieving successful IVF outcomes.
- Accurate prediction of ovarian stimulation response is crucial for managing DOR patients.
- Traditional AMH assays may have limitations in detecting low levels predictive of poor response.
Purpose of the Study:
- To evaluate the predictive capability of a novel, lower-detection antimüllerian hormone (AMH) enzyme-linked immunosorbent assay (picoAMH ELISA).
- To determine if picoAMH ELISA can predict successful ovarian stimulation in women diagnosed with diminished ovarian reserve (DOR).
- To establish a predictive AMH threshold for successful oocyte retrieval in DOR patients undergoing IVF.
Main Methods:
- Retrospective case-control study involving 48 patients (24 cases, 24 controls) from a university-based IVF program.
- Serum samples from DOR patients before their first IVF cycle were analyzed using the picoAMH ELISA.
- Cases: IVF cancelled due to poor response (<3 follicles). Controls: ≥3 oocytes retrieved (FSH ≥10 IU/L).
Main Results:
- The successful oocyte retrieval group exhibited significantly higher AMH levels (847 pg/mL vs. 406 pg/mL) and antral follicle count (8.5 vs. 6) compared to the failed stimulation group.
- AMH levels strongly correlated with antral follicle count (R = 0.61).
- A picoAMH ELISA threshold of >500 pg/mL demonstrated 83.3% sensitivity and 70.8% specificity for predicting successful oocyte retrieval; levels <100 pg/mL precluded retrieval.
Conclusions:
- The picoAMH ELISA, with its lower detection threshold, shows promise in predicting successful ovarian stimulation in women with DOR.
- An AMH threshold of 500 pg/mL using picoAMH ELISA is a reliable indicator for predicting successful oocyte retrieval in this population.
- This assay may improve the management and counseling of DOR patients undergoing IVF.
