Impact of antimullerian hormone and cytokines in prediction of in vitro fertilization outcome

ABSTRACT IMPACT OF ANTIMULLERIAN HORMONE AND CYTOKINES IN PREDICTION OF IN VITRO FERTILIZATION OUTCOME Prediction of ovarian response before starting treatment of controlled ovarian hyperstimulation (COH) reduce cycle cancellations and provides the physician the opportunity to develop appropriate treatment strategies. Anti-mullerian hormone (AMH) levels are arranged in paralel with the development phases of oocytes in the pre-antral, late pre-antral and preovulatory follicles and it is charged in coordination with follicular development. Bone morphogenetic protein-15 (BMP-15) is involved in transition of phases of primordial-primary, pre-antral-antral follicle and inhibites premature luteinizing by the inhibition of the synthesis of progesterone (P4). In this study; we aimed to evaluate the importance of AMH, and BMP-15 for prediction ovarian response. This prospective, randomized, cross-sectional study was carried out with 80 patients during 01.06.2012-01.06.2013 in IVF Center of Firat University Hospital. Patients were divided into two groups as fallows; gonadotropin-releasing hormone (GnRH) agonist (G1, n = 38) and GnRH antagonist (G2, n=44). Approximately eight ml of peripheral venous blood was collected from patients on the third day of the menstrual cycle and on the day of the collected samples pick oocyte up (OPU) and also follicular fluid was collected during OPU. Bloods were centrifuged and the serum samples were stored at -20 °C until analysis. Analysis of AMH, and BMP-15 were performed quantitatively by ELISA method. The mean age of the patients was significantly lower in G1 than G2 (p <0.05); antral follicle counts (AFC), estradiol (E2) levels on day of human chorionic gonadotropin (HCG) and the number ofoocytes collected were significantly higher. D3 and with the blood of the OPU and levels of BMP-15; D3 and AMH levels of OPU blood were similar in G1 and G2 (p>0,05). Follicle fluid AMH levels were significantly higher in G2 (p <0,05). When each group was compared with each other, the difference was statistically significant between D3, level of AMH of OPU blood and level of AMH of follicular fluid (p<0,017). While the levels of OPU BMP-15 were similar with the level of D3 BMP-15 (p>0,017), the difference with levels of BMP-15 in follicular fluid between them were statistically significant (p <0.017). The significant negative correlation was identified between fertilization rates (FR) and blood level of AMH on D3 and OPU, blood level of BMP-15 on OPU. In conclusion to discuss our results, the broader populated studies which examined of the levels of AMH and BMP-15 are needed. Key Words: in vitro fertilization, ovarian reserve, BMP-15, AMH