Assessment of the relationship of basal serum anti-mullerian hormone levels with oocyte quality and pregnancy outcomes in patients undergoing ICSI

Anti-Mullerian hormone [AMH] is constantly secreted during menstrual cycles and may offer several advantages over traditional biomarkers of ovarian reserve. To assess the relationship of anti-Mullerian hormone [AMH] values, which are used to evaluate ovary reserves, with oocyte and embryo quality and with ART outcomes in patients undergoing intra-cytoplasmic sperm injection [ICSI]. This cross sectional study was performed using 50 women undergoing ICSI in IVF center of Zeynep Kamil Women's and Children's Hospital, Istanbul, Turkey. All patients received the long protocol. Follicle-stimulating hormone, luteinizing hormone, estradiol, and AMH levels were measured and antral follicle counts were obtained on the 3[rd] day of menstruation. A cut-off value based on the number of oocytes was determined for AMH, and women were evaluated after being divided into two groups as bad responders and good responders, according to their AMH levels. Twelve [27.3%] women were in bad responders group and 32 [72.7%] women were in good responders group. AMH measurements were statistically significantly different between the two groups [p<0.01]. Based on this significance, the researchers used ROC analysis to estimate a cut-off point for AMH. The researchers detected the good responders with an AMH level 1.90 or above, with 87.50% sensitivity, 66.67% specificity, 87.50% positive prediction, and 66.67% negative prediction [AUC=0.777, p<0.01]. Basal AMH levels can be used as an indicator to determine the ovarian response in women undergoing ICSI. AMH can be used to predict the number of mature oocytes that can be collected during treatment and the number of oocytes that can be fertilized. However, AMH is not a valuable tool to evaluate oocyte quality, the development of high-quality embryos, or pregnancy conception

Predictive factors influencing pregnancy rates after intrauterine insemination

So far, many studies investigated factors that affect pregnancy rates after intrauterine insemination [IUI]. Various investigators have not agreed on the nature and ranking of these criteria. The aim of this study was to assess the predictive factors for pregnancy rate after controlled ovarian hyperstimulation [COH]/ IUI. Retrospective study of all patients undergoing IUI at Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital from January 2006 to December 2009. In total 980 IUI cycles in 569 couples were analyzed. All women in the study underwent ovarian stimulation using gonadotropin and IUI was performed 36 h after triggering ovulation. The primary outcome measure was clinical pregnancy rates. Predictive factors evaluated were female age, body mass index [BMI], duration of infertility, type of infertility, follicle stimulating hormone [FSH] level and estradiol [E[2]] on third day of the cycle, number of preovulatory follicles, endometrial thichness, total motil sperm [TMS] count, and ratio of progressive motile sperm. The overall clinical pregnancy rate was 4.7%. Among the predictive factors after multivariate logistic regression analysis level of BMI [<25 kg/m[2]], number of preovulatory follicles [> =2], level of FSH [<9.4 IU/L], level of E2 [<80 pg/ml] and the ratio of progressive motile sperm [>50%] significantly influenced the clinical pregnancy rate. Level of BMI, FSH, estradiol, number of preovulatory follicles and the ratio of progressive motile sperm may determine IUI procedure as optimum treatment model