The assessment of ovarian reserve in women with unexplained infertility is needed for predicting response to controlled ovarian stimulation. This helps in appropriate pretreatment counselling and in modification of an individual’s treatment protocol to maximize the potential response.
Aims and Objectives: 1. To determine the correlation of Follicle Stimulating Hormone (FSH), AntiMullerian Hormone (AMH) and Antral Follicle Count(AFC) with ovarian response in patients with unexplained infertility undergoing ovulation induction. 2. To determine the best parameter among the above in predicting response to ovarian stimulation.
Type of study: Prospective, correlational study.
Materials and Methods: Seventy women with unexplained infertility received treatment in the form of ovulation induction and timed intercourse/IUI. They had basal Serum FSH, Serum AMH assessment on Day 3 of the menstrual cycle. AFC was assessed with transvaginal sonography (TVS) on Day 3 of the cycle. The response to stimulation was measured in terms of the number of follicles >/= 16mm on TVS on the day of Inj HCG administration. >/= 3 follicles which were >/= 16 mm was considered a good response. The response was correlated to the levels of FSH, AMH and AFC.
Results and Conclusion: There were 50 good responders, ie; with >/= 3 follicles>/= 16 mm on the day of HCG. 20 women responded with < 3 follicles >/=16 mm on the day of HCG – the poor responders. There was significant statistical correlation between age among good and poor responders. AFC and AMH were found to correlate significantly with ovarian response with p value <0.001. AFC was as accurate as AMH in predicting response.
Basal FSH did not correlate with the ovarian response indicating its poor value as a predictor of ovarian reserve.