Anti-Mullarian hormone versus day three follicular stimulating hormone and antral follicular count as a predictor for ovarian response to stimulation

Recently, a new marker, the anti-mullarian hormone (AMH), has been evaluated as a marker of ovarian response. Since the number of ovarian follicles decline with increasing age, AMH level might be used as a marker for ovarian aging, and serum AMH can be measured at frequent time-points during menstrual cycle, suggesting the complete absence of fluctuation. To evaluate wither anti-Mullarian hormone is a better predictor of ovarian response to stimulation in comparism to day 3 follicular stimulating hormone (FSH) and antral follicular count (AFC). This study was carried out at Bint AL-Huda teaching hospital in Thi-qar and Basrah IVF center during the period from 1st January 2012-1st January 2013 including 60 women with infertility caused by anovulation, and they were assesd by doing day 3 FSH, AMH and AFC, then they were subjected to ovulation induction treatment using clomiphene citrate 50 mg three times daily from day 2-6 of menstrual cycle and then assess at day 7 with transvaginal u/s and serum oestradiol level for the size and numbers of mature graffian follicle, if they were not responding to clomiphene citrate tablet they were given 3 ampules of follicular stimulating hormone ( follitropin beta ) (50iu/0.5ml) at day 7, 8, and 9 of menstrual cycle, on day 10-11 of menstrual cycle the MGF was assessed for the numbers and size and serum sample obtained for measurement of oestradiol level. The data were analyzed by using ttest, pearson correlation, regression coefficient and area under receiver operating curve (ROC) was calculating as measure of predictive accuracy.