Ovarian biomarkers predict controlled ovarian stimulation for in vitro fertilisation treatment in Singapore.
INTRODUCTION
Ovarian biomarkers have been shown to predict responses to controlled ovarian hyperstimulation (COH) during in vitro fertilisation (IVF) in predominantly Caucasian populations, with limited studies performed in Southeast Asian women in Singapore.


METHODS
We evaluated the performance of serum anti-Müllerian hormone (AMH), follicle-stimulating hormone and oestradiol levels, antral follicle count (AFC), body mass index, ovarian volume, and age to establish thresholds for the prediction of poor (< 4 oocytes retrieved) and excessive responses (> 19 oocytes retrieved) in 263 women undergoing COH. Univariate and multivariate logistic regression analysis and receiver operating characteristic curves were used to calculate probabilities for poor and excessive responders to COH.


RESULTS
36 (13.7%) and 50 (19.0%) women had poor and excessive response to COH, respectively. An AMH value of 0.69 ng/mL predicted poor ovarian response with positive likelihood ratio (LR) of 2.94, compared to an AFC of ≤ 5 when the positive LR is 2.36. Conversely, an AMH value of ≥ 3.06 ng/mL predicted excessive ovarian response with positive LR of 2.24, compared to an AFC cut-off of ≥ 12 with positive LR of 1.93.


CONCLUSION
AMH levels and AFC are equivalent in the prediction of both poor and excessive ovarian response in women undergoing IVF. Our study highlights the importance of establishing population-specific cut-off biomarker values so that protocols can be tailored to optimise IVF treatment.
['Lee|Ryan Wai Kheong|RWK|', 'Khin|Lay Wai|LW|', 'Hendricks|Marianne Sybille|MS|', 'Tan|Heng Hao|HH|', 'Nadarajah|Sadhana|S|', 'Tee|Nancy Wen Sim|NWS|', 'Loh|Seong-Feei|SF|', 'Tai|Bee Choo|BC|', 'Chan|Jerry Ky|JK|']
D015415:Biomarkers D005260:Female D005307:Fertilization in Vitro D006801:Humans D006080:Ovarian Follicle D010062:Ovulation Induction D012846:Singapore
ovarian biomarkers stimulation fertilisation