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Prediction of different ovarian responses using anti-Müllerian hormone following a long agonist treatment protocol for IVF

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Abstract

Objective

The purpose of this study was to predict the poor and excessive ovarian response using anti-Müllerian hormone (AMH) levels following a long agonist protocol in IVF candidates.

Research design and methods

Through a prospective cohort study, the type of relationship and appropriate scale for AMH were determined using the fractional polynomial regression. To determine the effect of AMH on the outcomes of ovarian stimulation and different ovarian responses, the multi-nominal and negative binomial regression models were fitted using backward stepwise method. The ovarian response of study subject who entered a standard long-term treatment cycle with GnRH agonist was evaluated using prediction model, separately and in combined models with (ROC) curves.

Results

The use of standard long-term treatments with GnRH agonist led to positive pregnancy test results in 30 % of treated patients. With each unit increase in the log of AMH, the odds ratio of having poor response compared to normal response decreases by 64 % (OR 0.36, 95 % CI 0.19–0.68). Also the results of negative binomial regression model indicated that for one unit increase in the log of AMH blood levels, the odds of releasing an oocyte increased 24 % (OR 1.24, 95 % CI 1.14–1.35). The optimal cut-off points of AMH for predicting excessive and poor ovarian responses were 3.4 and 1.2 ng/ml, respectively, with area under curves of 0.69 (0.60–0.77) and 0.76 (0.66–0.86), respectively.

Conclusion

By considering the age of the patient undergoing infertility treatment as a variable affecting ovulation, use of AMH levels showed to be a good test to discriminate between different ovarian responses.

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Acknowledgments

The author would like to thank Infertility and Reproductive Health Research Center of Shahid Beheshti University of Medical Sciences for their financial support of this study.

Conflict of interest

The authors have stated explicitly that there are no conflicts of interest in connection with this article.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

All the individuals had been informed of the purposes of the study and gave their oral informed consent.

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Authors and Affiliations

  1. Infertility and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Z. Heidar, M. Mirzamoradi & S. Zadehmodarres

  2. Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    M. Bakhtiyari

  3. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

    M. Bakhtiyari & M. A. Mansournia

  4. Department of Obstetrics and Gynecology, Mahdiyeh Hospital, Infertility and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    F. S. Sarfjoo

Authors
  1. Z. Heidar
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  2. M. Bakhtiyari
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  3. M. Mirzamoradi
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  4. S. Zadehmodarres
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  5. F. S. Sarfjoo
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  6. M. A. Mansournia
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Corresponding author

Correspondence to F. S. Sarfjoo.

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Heidar, Z., Bakhtiyari, M., Mirzamoradi, M. et al. Prediction of different ovarian responses using anti-Müllerian hormone following a long agonist treatment protocol for IVF. J Endocrinol Invest 38, 1007–1015 (2015). https://doi.org/10.1007/s40618-015-0297-4

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  • DOI: https://doi.org/10.1007/s40618-015-0297-4

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