• Ryan Wai Kheong Lee, Lay Wai Khin, Marianne Sybille Hendricks, Heng Hao Tan, Sadhana Nadarajah, TeeNancy Wen SimNWSDepartment of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore., Seong-Feei Loh, Bee Choo Tai, and Jerry Ky Chan.
• Department of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore.
• Singap Med J. 2020 Sep 1; 61 (9): 463-468.

IntroductionOvarian 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.MethodsWe 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.Results36 (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.ConclusionAMH 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.Copyright: © Singapore Medical Association.

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