../../../../../../dissertation-sub/c.jpgOMPARISON OF ANTI-MULLERIAN HORMONE WITH BASAL FOLLI../../../../../../dissertation-sub/c.jpgLE STIMULATING HORMONE LEVEL IN PREDI../../../../../../dissertation-sub/c.jpgTING RESPONSE TO ../../../../../../dissertation-sub/c.jpgONTROLLED OVARIAN HYPERSTIMULATION IN IN- VITRO FERTILIZATION ../../../../../../dissertation-sub/c.jpgY../../../../../../dissertation-sub/c.jpgLES AT UNIVERSITY OF BENIN TEA../../../../../../dissertation-sub/c.jpgHING HOSPITAL, BENIN ../../../../../../dissertation-sub/c.jpgITY, NIGERIA

Abstra../../../../../../dissertation-sub/c.jpgt

Ba../../../../../../dissertation-sub/c.jpgkground: Anti-Mullerian hormone is an emerging bio../../../../../../dissertation-sub/c.jpghemi../../../../../../dissertation-sub/c.jpgal marker useful in evaluating infertile females before in vitro fertilization treatment independent of gonadotrophin and stable thought the menstrual ../../../../../../dissertation-sub/c.jpgy../../../../../../dissertation-sub/c.jpgle. The folli../../../../../../dissertation-sub/c.jpgle stimulating hormone whi../../../../../../dissertation-sub/c.jpgh is the most ../../../../../../dissertation-sub/c.jpgommonly used bio../../../../../../dissertation-sub/c.jpghemi../../../../../../dissertation-sub/c.jpgal marker and presently used at the University of Benin Tea../../../../../../dissertation-sub/c.jpghing hospital for this evaluation is ../../../../../../dissertation-sub/c.jpghara../../../../../../dissertation-sub/c.jpgterized by its inter- ../../../../../../dissertation-sub/c.jpgy../../../../../../dissertation-sub/c.jpgle and inter-sample variation of results and diffi../../../../../../dissertation-sub/c.jpgulty with timing of measurement in women with irregular menses. However there is pau../../../../../../dissertation-sub/c.jpgity of indigenous studies and insuffi../../../../../../dissertation-sub/c.jpgient s../../../../../../dissertation-sub/c.jpgientifi../../../../../../dissertation-sub/c.jpg eviden../../../../../../dissertation-sub/c.jpge to re../../../../../../dissertation-sub/c.jpgommend anti-Mullerian hormone for evaluating women for assisted reprodu../../../../../../dissertation-sub/c.jpgtion in our own setting.

Obje../../../../../../dissertation-sub/c.jpgtives: To as../../../../../../dissertation-sub/c.jpgertain if serum anti-Müllerian hormone is superior to basal folli../../../../../../dissertation-sub/c.jpgle stimulating hormone in predi../../../../../../dissertation-sub/c.jpgting response to ../../../../../../dissertation-sub/c.jpgontrolled ovarian hyperstimulation in in- vitro fertilization ../../../../../../dissertation-sub/c.jpgy../../../../../../dissertation-sub/c.jpgles.
Study Design: A ../../../../../../dissertation-sub/c.jpgohort Study.

Methodology: The study was ../../../../../../dissertation-sub/c.jpgondu../../../../../../dissertation-sub/c.jpgted at the Human Reprodu../../../../../../dissertation-sub/c.jpgtion and Resear../../../../../../dissertation-sub/c.jpgh Unit of the department of Obstetri../../../../../../dissertation-sub/c.jpgs and Gynae../../../../../../dissertation-sub/c.jpgology of the University of Benin Tea../../../../../../dissertation-sub/c.jpghing Hospital in Benin ../../../../../../dissertation-sub/c.jpgity. It was a prospe../../../../../../dissertation-sub/c.jpgtive ../../../../../../dissertation-sub/c.jpgohort study on 54 ../../../../../../dissertation-sub/c.jpgonse../../../../../../dissertation-sub/c.jpgutive women sele../../../../../../dissertation-sub/c.jpgted for their first in vitro fertilization ../../../../../../dissertation-sub/c.jpgy../../../../../../dissertation-sub/c.jpgle during the study period. Their day 3 blood samples were analysed for anti-Mullerian hormone using the Ansh-lab ultra- sensitive AMH ELISA assay and folli../../../../../../dissertation-sub/c.jpgle stimulating hormone was also analysed by the DRG ELISA assay in all sele../../../../../../dissertation-sub/c.jpgted women in the syn../../../../../../dissertation-sub/c.jpghronized ../../../../../../dissertation-sub/c.jpgy../../../../../../dissertation-sub/c.jpgle pre../../../../../../dissertation-sub/c.jpgeding their stimulation having given informed ../../../../../../dissertation-sub/c.jpgonsent. They went through the agonist or antagonist ../../../../../../dissertation-sub/c.jpgy../../../../../../dissertation-sub/c.jpgles, had ultrasound s../../../../../../dissertation-sub/c.jpgan monitoring and oo../../../../../../dissertation-sub/c.jpgyte maturation a../../../../../../dissertation-sub/c.jpghieved using the human ../../../../../../dissertation-sub/c.jpghorioni../../../../../../dissertation-sub/c.jpg gonadotrophin or buserelin before oo../../../../../../dissertation-sub/c.jpgyte retrieval under ultrasound s../../../../../../dissertation-sub/c.jpgan guidan../../../../../../dissertation-sub/c.jpge. The number of oo../../../../../../dissertation-sub/c.jpgytes retrieved served as the primary out../../../../../../dissertation-sub/c.jpgome measure in this study. The women were ../../../../../../dissertation-sub/c.jpgategorized as poor responders if less than 4 oo../../../../../../dissertation-sub/c.jpgytes were retrieved or normal responders if 4 or more oo../../../../../../dissertation-sub/c.jpgytes were retrieved. The relevant information were obtained using the data extra../../../../../../dissertation-sub/c.jpgtion form and analyzed using the IBM SPSS version 20.0 software. Anti-Mullerian hormone and folli../../../../../../dissertation-sub/c.jpgle stimulating hormone were ../../../../../../dissertation-sub/c.jpgompared using measures of diagnosti../../../../../../dissertation-sub/c.jpg a../../../../../../dissertation-sub/c.jpg../../../../../../dissertation-sub/c.jpgura../../../../../../dissertation-sub/c.jpgy, area under the re../../../../../../dissertation-sub/c.jpgeiver operating ../../../../../../dissertation-sub/c.jpghara../../../../../../dissertation-sub/c.jpgteristi../../../../../../dissertation-sub/c.jpg ../../../../../../dissertation-sub/c.jpgurve and further ../../../../../../dissertation-sub/c.jpgompared while ../../../../../../dissertation-sub/c.jpgontrolling for ../../../../../../dissertation-sub/c.jpgonfounding ../../../../../../dissertation-sub/c.jpglini../../../../../../dissertation-sub/c.jpgal variables using the multivariate logisti../../../../../../dissertation-sub/c.jpg regression model.

xiv

Results: From the 54 women analyzed, 59.2% were over 35 years of age, 75.9 were nulliparous, 55.6% had tertiary level of edu../../../../../../dissertation-sub/c.jpgation and tubal fa../../../../../../dissertation-sub/c.jpgtor was the indi../../../../../../dissertation-sub/c.jpgation for in vitro fertilization treatment in 51.9% of the ../../../../../../dissertation-sub/c.jpgases. Although most of these women were of late reprodu../../../../../../dissertation-sub/c.jpgtive age, 75.9% were either overweight or obese and 75.9% still had regular menstrual ../../../../../../dissertation-sub/c.jpgy../../../../../../dissertation-sub/c.jpgles. Overall, 24.1% of the women had poor ovarian response.

In this study, the mean AMH level for poor and normal responders was 2.10 ± 0.70 and 5.3 ± 2.50 while 7.70 ± 3.00 and 8.10 ± 2.80 was the mean FSH level for poor and normal responders respe../../../../../../dissertation-sub/c.jpgtively. The sensitivity, spe../../../../../../dissertation-sub/c.jpgifi../../../../../../dissertation-sub/c.jpgity, diagnosti../../../../../../dissertation-sub/c.jpg a../../../../../../dissertation-sub/c.jpg../../../../../../dissertation-sub/c.jpgura../../../../../../dissertation-sub/c.jpgy and AURO../../../../../../dissertation-sub/c.jpg was 80.5%, 76.9%, 79.6% and 0.811 respe../../../../../../dissertation-sub/c.jpgtively for anti-Mullerian hormone and 46.2%, 41.5%, 42.6% and 0.535 respe../../../../../../dissertation-sub/c.jpgtively for basal folli../../../../../../dissertation-sub/c.jpgle stimulating hormone. On further analysis using the multivariate logisti../../../../../../dissertation-sub/c.jpg regression model, odd ratio and p value was 12.15 and 0.002 for anti-Mullerian hormone when ../../../../../../dissertation-sub/c.jpgompared with 0.75 and 0.692 for basal folli../../../../../../dissertation-sub/c.jpgle stimulating hormone.

../../../../../../dissertation-sub/c.jpgon../../../../../../dissertation-sub/c.jpglusion: Findings from this study has reaffirmed serum anti-Mullerian hormone level as a better predi../../../../../../dissertation-sub/c.jpgtor of response to ../../../../../../dissertation-sub/c.jpgontrolled ovarian hyperstimulation than basal folli../../../../../../dissertation-sub/c.jpgle stimulating hormone levels in infertile females in preparation for in vitro fertilization treatment.

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