Evaluation of Ovarian Response Indexes as Predictors to the Outcome of Intracytoplasmic Sperm Injection

Abstract

Abstract Background: Knowing predictors of pregnancy in assistant reproductive technology, knowing of predictors of pregnancy is helpful for clinicians to individualize treatment 14 Plans and improve patient counseling, and for patients to decide whether to undergo infertility treatment. Therefore, it is important to evaluate ovarian reserve prediction indexes as an index to predict response to assistant reproductive technology. Objectives: To evaluate the ovarian reserve index (AMH*AFC/Age), taking into account the total number of MII oocytes retrieved and the quality of embryo obtained as well as the pregnancy rate. Materials and Methods: This study is designed as a cohort prospective study and was conducted in Al-Sadder Teaching Medical City, Al Najaf Province. Sixty couples were enrolled. The gynecological examination was performed on day 2 of the cycle (CD2): vaginal ultrasound (U/S) and blood tests for FSH, LH, AMH, estradiol (E2), serum prolactin, and thyroid function test. The ovarian response prediction index (OPRI) values were measured by multiplying the AMH serum level (ng/mL) by the number of antral follicles with a diameter of 2–9 mm and then dividing the result by the age of the subjects (years). Results: The current study showed that the pregnancy rate of the studied group was 33.33%. There was a significant difference between pregnant and nonpregnant women in their AMH level (P value was 0.004). ORPI was significantly higher in pregnant women than nonpregnant women. Binary logistic regression analysis shows that there was a significant positive correlation of ORPI and higher AMH, AFC, lower BMI, MII, oocytes, and embryo number. ROC curve shows that ORPI had an AUC of 1.00 at cutoff point 2, giving a sensitivity and specificity of 97% and 100%, respectively, and an AUC of 1.00 at a cutoff point 1, giving a sensitivity and specificity of 100% and 95%, respectively, which indicate that ORPI is an important predicting factor for ICSI success rate. Conclusion: ORPI was significantly higher in pregnant women than in the nonpregnant group; AMH was significantly higher in pregnant women than in the nonpregnant group. Women with higher AMH, AFC, and lower BMI are more likely to have higher ORPI.