2006, Number 01
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Ginecol Obstet Mex 2006; 74 (01)
Statistical and prognostic correlation of serum levels of basal inhibin to response and follicular quality in assisted reproduction
Ruíz AJ, Carballo ME, Durán ML, Corona LC, Karchmer KS
Language: Spanish
References: 13
Page: 29-36
PDF size: 103.15 Kb.
ABSTRACT
Background: Inhibin B is a direct marker of ovarian reserve and one of the earliest markers of ovarian aging. It has been used in assisted reproduction programs as a serum marker that can identify an altered follicular reserve and predict a good or poor response to the stimulation with exogenous gonadotropins.
Objective: To correlate inhibin B levels with follicular response and quality of oocytes obtained through ovarian stimulation controlled in an in vitro fertilization cycle (IVFET), as well as relate it with variables such as: fertilization percentage and pregnancy rates.
Patients and methods: In a prospective and transversal study we included 71 patients that entered the IVFET program (February-April 2005). We determined inhibin B levels at the third day of the cycle and evaluated the follicular response and the oocyte quality during the ovarian stimulation, as well as fertilization and pregnancy rates. Statistical analysis was made with Spearman’s and ANOVA tests.
Results: We observed a positive correlation between inhibin levels and quantity of developed follicles (0.457), number of captured oocytes (0.390), and quantity of metaphase II oocytes (0.324). We observed better oocyte quality in women with inhibin levels › 251 pg/mL, and we considered that the ones that had levels ‹ 50 pg/mL had poor follicular response (19.71%). There was no correlation with fertilization and pregnancy rates.
Conclusions: In the early follicular phase inhibin B has direct correlation with ovarian reserve. Its high levels are related to better follicular response and oocyte quality. This enzyme levels are not useful as a predictive factor of pregnancy in IVFET cycles.
REFERENCES
Navarro J, Schattman GL, Rosenwaks Z. La baja respondedora a los protocolos de estimulación ovárica. En: Remohi J, Pellicer A, Simón C, Navarro J. 2ª ed. Madrid: McGraw-Hill 2002;pp:65-78.
Séller DB, Lambert-Messerlian G, Hogan JW, Gardiner AC, et al. Day 3 serum inhibin-B is a predictive of assisted reproductive technologies outcome. Fertil Steril 1997;67:110-4.
Groome NP, Illingworth PJ, O’Brien M, Pai R, et al. Measurement of dimeric inhibin B throughout the human menstrual cycle. J Clin Endocrinol Metab 1996;81:1401-5.
Groome NP, Illingworth PJ, O’Brien M, Cooke I, et al. Detection of dimeric inhibin throughout the human menstrual cycle by two-site enzyme inmunoassay. Clin Endocrinol 1994;40:717-23.
Casper FW, Seufer RJ, Schaffrath M, Pollow K. Concentrations of inhibins and activin in women undergoing stimulation with recombinant follicle-stimulating hormone for in vitro fertilization treatment. Fertil Steril 2001;75:32-37.
Dokras A, Habana A, Giraldo J, Jones E. Secretion of inhibin B during ovarian stimulation is decreased in infertile women with endometriosis. Fertil Steril 2000;74:35-40.
Urbanczek J, Erik Hauzman, Klinga K, Rabe T, et al. Use of serum inhibin B levels at the start of ovarian stimulation and at oocyte pickup in the prediction of assisted reproduction treatment outcome. Fertil Steril 2005;83:341-8.
Creus M, Peñarrubia J, Fábregues F, Vidal E, et al. Day 3 serum inhibin B and FSH and age as predictors of assisted reproduction treatment outcome. Hum Reprod 2000;15:2341-6.
Hall E, Welt CK, Cramer DW. Inhibin A and inhibin B reflect ovarian function in assisted reproduction but are less useful at predicting outcome. Hum Reprod 1999;14:409-15.
Corson SL, Gutmann J, Batzer FR. Inhibin B as a test of ovarian reserve for infertile women. Hum Reprod 1999;14:2818-21.
Kably AA, Ruiz AJ, Carballo ME, Corona de LC, Karchmer KS. Correlación entre las concentraciones intrafoliculares de la superóxido dismutasa y la calidad ovocitaria, las tasas de fertilización y el desarrollo embrionario. Ginecol Obstet Mex 2004;72:335-44.
McLachlan RI, Robsertson DM, Healy DL, De Krester DM, Burger HG. Plasma inhibin levels during gonadotrophin induced ovarian hyperstimulation for IVF: a new index of follicular function? Lancet 1986;327:1233-4.
Dzik A, Lambert G, Izzo VM, Borges J, et al. Inhibin B response to EFORT is associated with the outcome of oocyte retrieval in the subsequent in vitro fertilization cycle. Fertil Steril 2000;74:1114-7.