Prediction of ovarian response by comparing basal markers of ovarian reserve in invitro fertilization

ABSTRACT

Sixty women undergoing their first invitro fertilization cycle [IVF] were included in this prospective study which was performed at Al-Azhar University Hospital, Dammieta from April 2003 to May 2005 to identify and compare predictors of poor ovarian response in IVF. The number of antral follicles and total ovarian volume were measured by transvaginal ultrasound [TVS] on cycle day 3 followed by the measurement of basal levels of follicle stimulating hormone [FSH], estradiol [E2] and inhibin B. The antral follicle count was the best single predictor for poor ovarian response Area under the receiver characteristic curve = 0.88. Addition of basal FSH and inhibin B levels to a logistic model with antral follicle count significantly improved the prediction of poor response. Addition of E2 and total ovarian volume didn't improve the prediction. On conclusion the antral follicle count provides better prognostic information on the occurrence of poor response during hormonal stimulation for IVF than does the currently used endocrine markers. However, addition of endocrine markers mainly FSH and inhibin provide more prediction