Inhibin B response to EFORT is associated with the outcome of oocyte retrieval in the subsequent in vitro fertilization cycle

Objective: To examine whether the magnitude of the rise in inhibin B levels after gonadotropin challenge is associated with subsequent response to ova rian stimulation during IVF. Design: Inhibin B serum levels after EFORT (exogenous follicle-stimulating hormone ovarian reserve test). Setting: Academic clinical practice. Patient(s): Serum samples from women who had undergone ovarian reserve scre ening with FSH in preparation for IVF. Thirteen of these women had a poor r esponse in IVF (canceled cycle for low estradiol and/or no oocytes retrieve d), and 19 had a good response (greater than or equal to 10 oocytes retriev ed). Intervention(s): EFORT test. Main Outcome Measure(s): Baseline(day 3) serum E-2 (bE(2)), FSH (bFSH), and inhibin B (bInhB) levels and inhibin B and E-2 levels 24 hours after EFORT (Delta InhB and DeltaE(2)). Result(s): The mean bInhB and Delta InhB levels were significantly higher i n good vs. poor responders. The odds ratio of having a good response for wo men with a Delta InhB of 202 pg/mL was 51.8 times (95% CI = 6.1-1,244) the corresponding odds for women with a Delta InhB of 49 pg/mL. As expected, De ltaE(2) was also significantly higher in good vs. poor responders; however, combination of DeltaE(2) plus Delta InhB did not improve the odds for pred icting IVF response. Conclusion(s): Our data suggest that Delta InhB after EFORT may provide a m ethod for predicting ovarian response to hyperstimulation in a subsequent I VF cycle. (Fertil Steril(R) 2000;74:1114-7. (C) 2000 by American Society fo r Reproductive Medicine).