COMPARISON OF ANTI-MULLERIAN HORMONE WITH BASAL FOLLICLE STIMULATING HORMONE LEVEL IN PREDICTING RESPONSE TO CONTROLLED OVARIAN HYPERSTIMULATION IN IN- VITRO FERTILIZATION CYCLES AT UNIVERSITY OF BENIN TEACHING HOSPITAL, BENIN CITY, NIGERIA
Background: Anti-Mullerian hormone is an emerging biochemical marker useful in evaluating
infertile females before in vitro fertilization treatment independent of gonadotrophin and stable
thought the menstrual cycle. The follicle stimulating hormone which is the most commonly used
biochemical marker and presently used at the University of Benin Teaching hospital for this
evaluation is characterized by its inter-cycle and inter-sample variation of results and difficulty
with timing of measurement in women with irregular menses. However there is paucity of
indigenous studies and insufficient scientific evidence to recommend anti-Mullerian hormone for
evaluating women for assisted reproduction in our own setting.
Objectives: To ascertain if serum anti-Müllerian hormone is superior to basal follicle stimulating
hormone in predicting response to controlled ovarian hyperstimulation in in-vitro fertilization
cycles.
Study Design: A Cohort Study.
Methodology: The study was conducted at the Human Reproduction and Research Unit of the
department of Obstetrics and Gynaecology of the University of Benin Teaching Hospital in Benin
City. It was a prospective cohort study on 54 consecutive women selected for their first in vitro
fertilization cycle during the study period. Their day 3 blood samples were analysed for antiMullerian hormone using the Ansh-lab ultra-sensitive AMH ELISA assay and follicle stimulating
hormone was also analysed by the DRG ELISA assay in all selected women in the synchronized
cycle preceding their stimulation having given informed consent. They went through the agonist
or antagonist cycles, had ultrasound scan monitoring and oocyte maturation achieved using the
human chorionic gonadotrophin or buserelin before oocyte retrieval under ultrasound scan
guidance. The number of oocytes retrieved served as the primary outcome measure in this study.
The women were categorized as poor responders if less than 4 oocytes were retrieved or normal
responders if 4 or more oocytes were retrieved. The relevant information were obtained using the
data extraction form and analyzed using the IBM SPSS version 20.0 software. Anti-Mullerian
hormone and follicle stimulating hormone were compared using measures of diagnostic accuracy,
area under the receiver operating characteristic curve and further compared while controlling for
confounding clinical variables using the multivariate logistic regression model.