Day 3 serum inhibin B and FSH and age as predictors of assisted reproduction treatment outcome

Recent reports investigating the value of basal inhibin B determination as a predictor of ovarian reserve and assisted reproduction treatment have led to discordant results. This study was undertaken to further assess the rel ative power of day 3 inhibin B and follicle stimulating hormone (FSH) (defi ned before treatment) and the woman's age both as single and combined predi ctors of ovarian response and pregnancy in an in-vitro fertilization (IVF)/ intracytoplasmic sperm injection (ICSI) programme. A total of 120 women und ergoing their first cycle of IVF or ICSI was included, Forty consecutive cy cles cancelled because of poor follicular response were initially selected. As a control group, the nearest completed IVF/ICSI cycles before and after each cancelled cycle (i.e. the closest cycles in temporal relationship to the index cycle) were used. Mean age and basal FSH concentrations were sign ificantly higher in the cancelled than in the control group (P < 0.01 and P < 0.001 respectively), whereas basal inhibin B was significantly higher in the latter (P < 0.05). The association of basal FSH (with an accuracy or p redictive value of ovarian response of 79%) with cancellation rate was sign ificant, independent of, and stronger than the effects of age and inhibin B (P < 0.05). Any two or all three of these variables studied did not improv e the predictive value of FSH alone, Woman's age was the only variable inde pendently associated with pregnancy rate, It is concluded that the stronger predictors of success in patients undergoing their first IVF/ICSI treatmen t cycle are age and basal FSH rather than inhibin B, Basal FSH concentratio n was a better predictor of cancellation rate than age, but age was a stron ger predictor of pregnancy rate.