Abstract

Background: Ovarian reserve assessment in Assisted Reproductive techniques (ART) and the decision based on its value is a diagnostic dilemma. Among the tests available to assess ovarian reserve, the most commonly used tests include FSH, AFC and AMH.

Objectives: To assess whether AMH or AFC is a better predictor of ovarian response (as evidenced by folliculogenesis) and cycle outcome in ART and also to see the correlation between AMH and AFC.

Material and Methods: This was a prospective comparative study conducted in the Department of Reproductive Medicine and Surgery at Amrita Fertility Centre, Kochi from July 2017 to September 2018. The study group comprised of 80 women recruited for ICSI. The number of follicles more than 12 mm on day of trigger was the primary outcome studied. After trigger and oocyte retrieval followed by ICSI the rest of the dependent parameters of COH were assessed including the pregnancy rate. Based on the AMH and AFC subgroups (low / normal/ high), the various parameters were compared. Results were analyzed using SPSS version 20.

Results: Eighty women who underwent COH and ICSI were followed up till 12 weeks of pregnancy. Patients divided into AMH and AFC low, normal and high groups. With respect to the follicle number, on comparing between the AMH and AFC groups there was no difference between the low, normal and high sub groups (p = 0.76).

Conclusion: AMH and AFC are having same ability and clinical value in prediction of ovarian response. So AFC may be considered as a substitute for the expensive AMH estimation in predicting the ovarian response to stimulation.

Keywords: Ante Mullerian Hormone, Antral Follicle Count, Controlled Ovarian Hyper stimulation, Follicle number, Pregnancy