The Value of Ovarian Reserve Tests in the Prediction of Poor Response to Controlled Ovarian Hyperstimulation

Background: To evaluate endocrine tests (FSH, LH, E2, Inhibin-B) and ovarian volume with respect to their ability to assess ovarian response in patients undergoing IVF/ICSI.Material and Methods: A total of 90 regularly menstruating patients undergoing their first IVF/ICSI cycle by standard long protocol, among them 60 patients were 35 years and 30 patients were 35 years. Measurement of cycle day 3 (CD3) FSH, LH, E2, Inhibin-B and ovarian volume. Controlled ovarian hyperstimulation (COH) started by 300IU HMG in young age group and 450IU in old age group and adjusted according to the ovarian response.Results: Univariate linear regression analysis showed that FSH, FSH/LH, Inhibin-B, stimulated cycle day 7 (sCD7) E2 and (sCD7) follicles 10mm were independent predictors of ovarian reserve. Multiple linear regression analysis showed that sCD7 follicles 10mm (100% accuracy in all age group), Inhibin-(3 (96.67%-88.33% accuracy among the young and old age group) and FSH/LH ratio (86.67-71.64% accuracy in young and old age group respectively) were the best predictors.Conclusions: Among all the investigated predictors stimulated sCD7 follicles 10mm was the best predictor of ovarian reserve tests (ORT) in all patients with the highest predictive accuracy. It could be considered a simple dynamic test identifying ovarian reserve.