Day 3 serum inhibin-B level is not predictive of ovarian assisted reproductive technologies outcome

Background: The ability of the ovary to respond to exogenous gonadotrophin stimulation and development of several follicles is essential in assisted reproductive technology. Neither age and regularity of menses nor follicular phase FSH and estradiol concentrations are reliable predictors of ovarian response. Day 3 serum inhibin-B level, during induction ovulation, has beenproposed as a predictor of ovarian response.
Objective: To determine day 3 serum inhibin-B as a predictor of ovarian response to induction ovulation in IVF/ ICSI cycles.
Materials and Methods: Seventy one infertile patients under 40 years old were enrolled in this study. All women have both ovaries, basal FSH level under 15 mIU/ml, and no evidence of endocrine disorders. Day 3 FSH, estradiol, inbibin-B concentrations and ovarian volume were measured before treatment. All patients underwent standard long GnRH agonist protocol. The number of oocytes retrieved, fertilization rate, clinical pregnancy rate, days of stimulation and number of HMG ampoules were determined. The patients were divided into two groups, normal responders and poor responders (number of oocytes retrived <4).
Results: The mean inhibin-B level in normal responders was 166.9± 141 pg/ ml versus 115.8 ±87 pg/ml in poor responders, which the difference was not statistically significant (p=0.24). We could not find a cut off between normal and poor responders.
Conclusion: The use of day 3 inhibin-B level as a predictive marker of ovarian response in IVF/ICSI cycles is not reliable.