Follicular fluid anti-Mullerian hormone and inhibin B concentrations: comparison between gonadotropin-releasing hormone (GnRH) agonist and GnRH antagonist cycles

Abstract

OBJECTIVE: To compare follicular fluid (FF) anti-Mullerian hormone (AMH) and inhibin B concentrations for GnRH agonist (GnRH-a) and GnRH antagonist cycles and to determine the correlations between FF AMH or inhibin B concentrations and controlled ovarian hyperstimulation (COH) outcomes. DESIGN: Prospective comparative study. SETTING: University hospital. PATIENT(S): Eighty-seven women who underwent COH cycles, either in the GnRH-a long-protocol group (n = 43) or the GnRH antagonist multiple-dose flexible-protocol group (n = 44). INTERVENTION(S): Follicular fluid was obtained from dominant follicles during oocyte retrieval, and FF AMH, inhibin B, E(2), and P concentrations were measured. Serum levels of AMH and inhibin B also were assessed on the day of oocyte retrieval. MAIN OUTCOME MEASURE(S): Follicular fluid AMH and inhibin B concentrations. RESULT(S): Concentrations of serum AMH and inhibin B and of FF AMH, inhibin B, E(2), and P were similar in the two groups. Follicular fluid AMH levels were found to be significantly correlated with age, gonadotropin dose, number of follicles on hCG day, and number of oocytes retrieved. CONCLUSION(S): Our results suggest that there is no significant difference in follicular microenvironment in terms of AMH and inhibin B secretion between GnRH-a and GnRH antagonist protocols and that FF AMH is a marker that reflects ovarian reserve and response to COH.