Serum AMH, estradiol and progesterone: is there a role in predicting the outcome in IVE?

To evaluate the role of antimullerian hormone and serum Estradiol in predicting the outcome in IVF, Prospective controlled trial. Egyptian Fertility center. 89 patients who suffer from infertility and are candidate for IVF are recruited for the study after consenting. Serum estradiol and progesterone are measured on day 1 of the cycle and on the day of HCG administration; we measure serum antimullerian hormone, estradiol and progesterone. The results are compared with the number of retrieved oocytes, number of tansferred embryos, pregnancy rat and incidence of twin pregnancy. The results are statistically analyzed. The age of the patients ranged from 22-45 years with a mean of 30.68 years. 4 patients of the 89 patients of the study got pregnant. There was significant difference between AMH and number of retrieved oocytes, the number of embryos as well as pregnancy rate. There is no significant correlation between AMH and twining. There is no significant correlation between serum estradiol at day 1 with either number of retrieved ooeytes, the number of embryos, pregnancy rate or twining. When we measure estradiol level at the date of HCG administration, there was a significant correlation with the number of retrieved oocytes and the number of embryos but with no significant correlation with pregnancy rate or twining. As regard to the progesterone level, there was no significant correlation with the number of retrieved oocytes, the number of embryos, pregnancy rate or twining at either progesterone levels at day 1 of the cycle or the day of HCG administration. When the estradiol level is below 50 pg/ml the AMH shows the most significant correlation with the number of retrieved oocytes, the number of embryos and pregnancy rate. The cut-off point or AMH is 0.3028 ng/ml below which we face poor ovarian response whereas that for estradiol at day 1 is 47.32 pg/ml. Both AMH and estradiol level at the day of HCG administration have a role in predicting the outcome of IVF in regard to the number of retrieved oocytes, the number of embryos and pregnancy rates in opposition which shows no actual relation to the IVF outcome parameters. In view of these laboratory investigations mainly AMH, our results do not recommend it as a routine procedure for women undergoing IVF. We can use them in patients whom we anticipate poor response in IVF program