OBJECTIVE

Anti-Mullerian hormone (AMH) has been used as the most valuable ovarian reserve marker and a good predictor of IVF outcomes. Some studies have shown that the day 3 FSH/LH ratio can be used as a IVF outcome predictor. The purpose of this study was to assess the values of AMH and day 3 FSH/LH ratio and their combination as predictors of IVF outcomes.

DESIGN

Retrospective study.

MATERIALS AND METHODS

We retrospectively reviewed 178 patients undergoing IVF using GnRH agonist and antagonist protocols from January 2010 to December 2010. Three groups of patients were formed based on Day 3 serum FSH/LH ratio. Group I consisted of patients with serum FSH/ LH <2, Group II consisted of patients with 2 > FSH/LH <3, Group III consisted of patients with FSH/LH≥3. Each group was divided into subgroups according to AMH (AMH<2, 2>AMH<5, AMH≥5).

RESULTS

In each group, the patients’ characteristics as measured by age, parity and cause of infertility reflected no difference. Group I (FSH/LH <2) had significantly higher pregnancy rates(PR) than Group II and Group III. [62.5%(45/72), 48.1%(26/54), 28.8%(15/52), P<0.05]. In group I (FSH/LH<2), when AMH was higher than 5, the PR was 75.0%(33/44). This percentage was higher than the PR of other subgroups [AMH<2: PR:30.8%(4/13), 2> AMH<5: PR:53.3%(8/15) ]. In group III (FSH/LH ≥3), when AMH was lower than 2, the PR was 14.3%(3/21). This rate was lower than the PRs of the other subgroups[2 >AMH<5:PR 32.0%(8/25), AMH≥5:50.0%(3/6) ]. The PRs were significantly different according to AMH. [AMH<2, PR 29.6%(16/ 54); 2>AMH<5, PR 44.3%(27/61); AMH≥5, PR 66.7%(42/63); P<0.05]

CONCLUSION

Day 3 FSH/LH ratio as well asAMHcan be used as a predictor of IVF prognosis. The data states that when day 3 FSH/LH ratio <2 and AMH≥5, we can anticipate higher PR(65.9%) but when day 3 FSH/ LH ratio≥3 and AMH<2, it is hard to expect good IVF outcomes(PR 14.3%). Therefore, when we combine day 3 FSH/LH ratio and AMH, we can predict IVF prognosis with higher accuracy.