Research question

What is the performance of anti-Müllerian hormone (AMH) as measured by the Elecsys® AMH assay in predicting ovarian response in women treated with 150 µg corifollitropin alfa (CFA)?

Design

Multicentre, prospective study conducted between December 2015 and April 2018. Women were aged 18–43 years, had regular menstrual bleeding, a body mass index of 17–35 kg/m² and weighed 60 kg or over. Exclusion criteria: previous oophorectomy, history of ovarian hyperstimulation syndrome, a previous IVF and intracytoplasmic sperm injection cycle producing over 30 follicles measuring 11 mm or wider, basal antral follicle count (AFC) over 20 or polycystic ovarian syndrome. All women were treated with 150 μg CFA followed by recombinant FSH (150–300 IU/day) in a fixed gonadotrophin releasing hormone antagonist protocol.

Results

Of the 219 patients enrolled, 22.8% had low ovarian response (three or fewer oocytes), 66.2% had normal response and 11% had high ovarian response (15 or more oocytes). The AMH and AFC presented an area under the curve of 0.883 (95% CI 0.830 to 0.936) and 0.879 (95% CI 0.826 to 0.930), respectively, for low ovarian response; and an AUC of 0.865 (95% CI 0.793 to 0.935) and 0.822 (95% CI 0.734 to 0.909) for high ovarian response. An AMH cut-off of 1.0 ng/ml provided a sensitivity of 92.0% and a specificity of 66.9% in the prediction of low ovarian response; a cut-off of 2.25 ng/ml predicted high ovarian response with a sensitivity of 54.2% and a specificity of 91.8%.

Conclusions

The automated Elecsys® AMH assay predicts ovarian response in a CFA antagonist protocol. The best predictors of ovarian response in CFA-treated patients were AMH and AFC.

中文翻译：

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Elecsys®抗苗勒氏管激素测定法在预测卵巢对促卵磷脂的最高反应方面的性能。

研究问题

通过Elecsys®AMH测定法测得的抗苗勒氏激素（AMH）在预测150 µgαrifolitropin alfa（CFA）治疗的妇女的卵巢反应中有什么作用？

设计

多中心，前瞻性研究在2015年12月至2018年4月间进行。女性年龄在18-43岁之间，月经有规律，体重指数为17-35 kg / m ²，体重60公斤或以上。排除标准：先前的卵巢切除术，卵巢过度刺激综合症的病史，先前的试管婴儿和胞浆内精子注射周期产生超过30个卵泡（尺寸大于11毫米），超过20个的基底窦卵泡计数（AFC）或多囊卵巢综合征。在固定的促性腺激素释放激素拮抗剂方案中，所有妇女均接受150μgCFA，然后进行重组FSH（150–300 IU /天）的治疗。

结果

在219名患者中，有22.8％的卵巢反应低（卵母细胞少于或少于3个），有66.2％的卵巢反应正常，有11％的卵巢反应高（有15个或更多卵母细胞）。对于低卵巢反应，AMH和AFC的曲线下面积分别为0.883（95％CI 0.830至0.936）和0.879（95％CI 0.826至0.930）。高卵巢反应的AUC为0.865（95％CI 0.793至0.935）和0.822（95％CI 0.734至0.909）。AMH临界值1.0 ng / ml在预测低卵巢反应方面提供了92.0％的灵敏度和66.9％的特异性。临界值为2.25 ng / ml时，可预测卵巢反应高，敏感性为54.2％，特异性为91.8％。

结论

自动化的Elecsys®AMH分析可预测CFA拮抗剂方案中的卵巢反应。在接受CFA治疗的患者中，卵巢反应的最佳预测指标是AMH和AFC。