Day 5 inhibin B serum concentrations as predictors of assisted reproductive technology outcome in cycles stimulated with gonadotrophin-releasing hormone agonist-gonadotrophin treatment

The present study investigates the usefulness of inhibin A, inhibin B and s erum oestradiol concentrations obtained in the fifth day of gonadotrophin t herapy in predicting ovarian response and assisted reproductive treatment o utcome in women undergoing ovarian stimulation under pituitary desensitizat ion. A total of 80 women undergoing their first cycle of in-vitro fertiliza tion (IVF)/intracytoplasmic sperm injection (ICSI) treatment were studied. Twenty consecutive cycles which were cancelled because of a poor follicular response were initially selected. As a control group, 60 women were random ly selected from our assisted reproductive treatment programme matching by race, age, body mass index, and indication for IVF/ICSI to those in the can celled group. For each cancelled cycle, three IVF/ ICSI women who met the m atching criteria were included. Basal follicle stimulating hormone (FSH) co ncentrations were significantly higher in the cancelled than in the control group, whereas basal inhibin B was significantly higher in the latter. Bas al oestradiol concentrations were similar in both groups of patients. On da y 5 of gonadotrophin therapy serum concentrations of oestradiol, inhibin A acid inhibin B were significantly lower in the cancelled group as compared with controls, Logistic regression analysis showed that the association for day 5 inhibin B (with a predictive value of ovarian response of 91.03%) wi th cancellation rate was significant, independent of, and stronger than, th e effects of any other hormone variable investigated. In addition, day 5 in hibin B concentrations were correlated directly with parameters of ovarian response, ovum retrieval and oocyte and fertilization outcome. However, day 5 inhibin B was not a better predictor of pregnancy than the other hormone variables studied on this day. It is concluded that inhibin B concentratio ns obtained early in the follicular phase during ovarian stimulation under pituitary suppression for assisted reproductive treatment are highly predic tive of ovarian response.