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Abstract

MEASUREMENT OF ANTI-MÜLLERIAN HORMONE IN SERUM AND FOLLICULAR FLUID AS A CORRELATION WITH ICSI OUTCOME

*Prof. Dr. Nawal Khairy Al-Ani., Dr. Layla Jumaa Hussein, Dr. Bushra Al-Musawi

ABSTRACT

Background: Anti-Müllerian hormone is a dimeric glycoprotein. In the ovary, it is exclusively produced by the granulosa, it has an important role in ovarian function, especially in follicle development and selection. The objectives of this study is to determine the usefulness of Anti-Müllerian hormone level in serum and follicular fluid on the day of oocyte pick up with the pregnancy outcome of intracytoplasmic sperm injection treatment. Forty infertile women undergoing intracytoplasmic sperm injection cycles were enrolled prospectively in this study in Kamal Al-Samarrai hospital for infertility and in-vitrofertilization (Baghdad/Iraq). All patients received midluteal long gonadotropin releasing hormone agonistprotocol. Serum and follicular fluid AMH levels were measured on the day of oocyte retrieval by using Enzyme Linked Immuno Sorbent Assay. The diagnostic accuracy of AMH in serum and follicular fluid, was assessed by the area under the receiver operating characteristic curve. Results: Ten women (25%) achieved pregnancy and was defined as pregnant group, while 30 women (75%) failed in achieving pregnancy who defined as nonpregnant group. The concentration of Anti- Müllerian Hormone in both serum and follicular fluid was significantly higher (P<0.05) in the pregnant group than in the non-pregnant group.Significant positive correlation (r=0.380, P<0.05) between serum and follicular fluid Anti- Müllerian Hormone.A significant positive correlation between serum Anti-Müllerian hormone and total oocyte number, metaphase II oocyte number, and fertilization rate.The diagnostic accuracy of serum Anti- Müllerian Hormone between the pregnant and the nonpregnant women was good, while follicular fluid Anti- Müllerian Hormone was poor because the results of the area under the receiver operating characteristic curve for Anti- Müllerian Hormone in serum and follicular fluid were (0.72and 0.340 respectively). We can conclude that serum AMH was significant and has more valid predictive value compared tofollicular fluid AMH in predicting pregnancy in women underwent intracytoplasmic sperm injection treatment.

Keywords: AMH, follicular fluid, ICSI, AUC.


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