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Reprod Biomed Online. 2017 May;34(5):534-540. doi: 10.1016/j.rbmo.2017.02.012. Epub 2017 Mar 2.

Ovarian response to 150 µg corifollitropin alfa in a GnRH-antagonist multiple-dose protocol: a prospective cohort study.

Author information

1
Department of Reproductive Medicine and Gynecological Endocrinology, University Hospital of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany.
2
Universitaeres Kinderwunschzentrum Kiel, Kiel, Germany.
3
Institute for Medical Biometrics and Statistics, University of Luebeck, Luebeck, Germany.
4
Kinderwunschzentrum Muenster, Muenster, Germany.
5
Department of Biology and Medical Genetics, University Hospital Motol, Prague, Czech Republic.
6
Klinikk Hausken, Haugesund, Norway.
7
Amedes Experts Hamburg, Hamburg, Germany.
8
Department of Reproductive Medicine and Gynecological Endocrinology, University Hospital of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany. Electronic address: georg.griesinger@uni-luebeck.de.

Abstract

The incidence of low (<6 oocytes) and high (>18 oocytes) ovarian response to 150 µg corifollitropin alfa in relation to anti-Müllerian hormone (AMH) and other biomarkers was studied in a multi-centre (n = 5), multi-national, prospective, investigator-initiated, observational cohort study. Infertile women (n = 212), body weight >60 kg, underwent controlled ovarian stimulation in a gonadotrophin-releasing hormone-antagonist multiple-dose protocol. Demographic, sonographic and endocrine parameters were prospectively assessed on cycle day 2 or 3 of a spontaneous menstruation before the administration of 150 µg corifollitropin alfa. Serum AMH showed the best correlation with the number of oocytes obtained among all predictor variables. In receiver-operating characteristic analysis, AMH at a threshold of 0.91 ng/ml showed a sensitivity of 82.4%, specificity of 82.4%, positive predictive value 52.9%and negative predictive value 95.1% for predicting low response (area under the curve [AUC], 95% CI; P-value: 0.853, 0.769-0.936; <0.0001). For predicting high response, the optimal threshold for AMH was 2.58 ng/ml, relating to a sensitivity of 80.0%, specificity 82.1%, positive predictive value 42.5% and negative predictive value 96.1% (AUC, 95% CI; P-value: 0.871, 0.787-0.955; <0.0001). In conclusion, patients with serum AMH concentrations between approximately 0.9 and 2.6 ng/ml were unlikely to show extremes of response.

KEYWORDS:

Corifollitropin alfa; GnRH antagonist; Ovarian hyperstimulation syndrome; Ovarian stimulation; Poor response; Response prediction

PMID:
28285952
DOI:
10.1016/j.rbmo.2017.02.012
[Indexed for MEDLINE]

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