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ISSN: 1734-1922
Archives of Medical Science
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vol. 14
Clinical research

Comparison of ovarian responsiveness tests with outcome of assisted reproductive technology – a retrospective analysis

Selcuk Selcuk, Bulent Emre Bilgic, Cetin Kilicci, Mehmet Kucukbas, Cetin Cam, Huseyin Tayfun Kutlu, Ates Karateke

Arch Med Sci 2018; 14, 4: 851–859
Online publish date: 2016/09/22
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This study aims to compare the association between the most commonly used ovarian responsiveness markers – age, anti-Müllerian hormone levels (AMH), antral follicle count (AFC), ovarian sensitivity index (OSI), and ovarian response prediction index (ORPI) – and ovarian responsiveness to gonadotropin stimulation in assisted reproductive technology (ART) cycles.

Material and methods
Patients who underwent intracytoplasmic sperm injection treatment using either a gonadotropin releasing hormone (GnRH) antagonist or agonist protocol were enrolled in the study. Data of the patients were abstracted from the hospital’s database. Tests were compared for total number of retrieved oocytes, metaphase II (MII) oocytes, embryos, good quality embryos on day 1 and day 3, and ongoing pregnancies per cycle.

The OSI was the ovarian response test that had the strongest relationship with the ART outcomes. The level of association between the ovarian response tests and poor ovarian response data was (in descending order): OSI, ORPI, AFC, AMH, and age (AUCOSI = 0.976, AUCORPI = 0.905, AUCAFC = 0.899, AUCAMH = 0.864, AUCage = 0.617). The overall association between OSI and poor ovarian response was significantly higher than the other parameters (p1 = 0.0023, p2 = 0.0014, p3 = 0.0001, p4  0.0001). In patients with high ovarian response data, OSI had the highest association, followed by AFC and ORPI age (AUCOSI = 0.984, AUCAFC = 0.907, AUCORPI = 0.887). There was no statistically significant difference among the tests for the data of patients with ongoing pregnancies.

In this study, which is the first study comparing the five most frequently used ovarian responsiveness markers and the second study signifying the role of OSI in an antagonist protocol, OSI was found to be more convenient to calculate, and it could be superior to other ovarian responsiveness markers for poor and high ovarian responses on cycles with agonist or antagonist protocols.


ovarian sensitivity index, ovarian response prediction index, assisted reproductive technology treatment, antral follicle counts, anti-Müllerian hormone

La Marca A, Ferraretti AP, Palermo R, Ubaldi FM. The use of ovarian reserve markers in IVF clinical practice: a national consensus. Gynecol Endocrinol 2016; 32: 1-5.
Holte J, Brodin T, Berglund L, Hadziosmanovic N, Olovsson M, Bergh T. Antral follicle counts are strongly associated with live-birth rates after assisted reproduction, with superior treatment outcome in women with polycystic ovaries. Fertil Steril 2011; 96: 594-9.
Tsakos E, Tolikas A, Daniilidis A, Asimakopoulos B. Predictive value of anti-Müllerian hormone, follicle-stimulating hormone and antral follicle count on the outcome of ovarian stimulation in women following GnRH-antagonist protocol for IVF/ET. Arch Gynecol Obstet 2014; 290: 1249-53.
Oner G, Ulug P, Elmali F. Ovarian reserve markers in unexplained infertility patients treated with clomiphene citrate during intrauterine insemination. Arch Med Sci 2015; 11: 1250-4.
Biasoni V, Patriarca A, Dalmasso P, et al. Ovarian sensitivity index is strongly related to circulating AMH and may be used to predict ovarian response to exogenous gonadotropins in IVF. Reprod Biol Endocrinol 2011; 9: 112.
Oliveira JB, Baruffi RL, Petersen CG, et al. A new ovarian response prediction index (ORPI): implications for individualised controlled ovarian stimulation. Reprod Biol Endocrinol 2012; 10: 94.
Van Royen E, Mangelschots K, De Neubourg D, et al. Characterization of a top quality embryo, a step towards single-embryo transfer. Hum Reprod 1999; 14: 2345-9.
Alpha Scientists in Reproductive Medicine and ESHRE Special Interest Group of Embryology. Balaban B, Brison D, Calderon G, et al. The Istanbul consensus workshop on embryo assessment: proceedings of an expert meeting. Hum Reprod 2011; 26: 1270-83.
Hanley JA, McNeil BJ. A method of comparing the areas under receiver operating characteristic curves derived from the same cases. Radiology 1983; 148: 839-43.
Younis JS, Jadaon J, Izhaki I, et al. A simple multivariate score could predict ovarian reserve, as well as pregnancy rate, in infertile women. Fertil Steril 2010; 94: 655-61.
Ferraretti AP, La Marca A, Fauser BC, Tarlatzis B, Nargund G, Gianaroli L. ESHRE consensus on the definition of ‘poor response’ to ovarian stimulation for in vitro fertilization: the Bologna criteria. Hum Reprod 2011; 26: 1616-24.
Broer SL, Dolleman M, Opmeer BC, Fauser BC, Mol BW, Broekmans FJ. AMH and AFC as predictors of excessive response in controlled ovarian hyperstimulation: a meta-analysis. Hum Reprod Update 2011; 17: 46-54.
Aflatoonian A, Oskouian H, Ahmadi S, Oskouian L. Prediction of high ovarian response to controlled ovarian hyperstimulation: anti-Mullerian hormone versus small antral follicle count (2–6 mm). J Assist Reprod Genet 2009; 26: 319-25.
Jayaprakasan K, Campbell B, Hopkisson J, Johnson I, Raine-Fenning N. A prospective, comparative analysis of anti-Mullerian hormone, inhibin-B, and three-dimensional ultrasound determinants of ovarian reserve in the prediction of poor response to controlled ovarian stimulation. Fertil Steril 2010; 93: 855-64.
Huber M, Hadziosmanovic N, Berglund L, Holte J. Using the ovarian sensitivity index to define poor, normal, and high response after controlled ovarian hyperstimulation in the long gonadotropin-releasing hormone-agonist protocol: suggestions for a new principle to solve an old problem. Fertil Steril 2013; 100: 1270-6.
Li HW, Lee VC, Ho PC, Ng EH. Ovarian sensitivity index is a better measure of ovarian responsiveness to gonadotrophin stimulation than the number of oocytes during in-vitro fertilization treatment. J Assist Reprod Genet 2014; 31: 199-203.
Brodin T, Hadziosmanovic N, Berglund L, Olovsson M, Holte J. Comparing four ovarian reserve markers – associations with ovarian response and live births after assisted reproduction. Acta Obstet Gynecol Scand 2015; 94: 1056-63.
Ledger WL. Measurement of antimüllerian hormone: not as straightforward as it seems. Fertil Steril 2014; 101: 339.
Rustamov O, Smith A, Roberts SA, et al. Anti-Mullerian hormone: poor assay reproducibility in a large cohort of subjects suggests sample instability. Hum Reprod 2012; 27: 3085-91.
Muzii L, Luciano AA, Zupi E, Panici PB. Effect of surgery for endometrioma on ovarian function: a different point of view. J Minim Invasive Gynecol 2014; 21: 531-3.
Iliodromiti S, Kelsey TW, Wu O, Anderson RA, Nelson SM. The predictive accuracy of anti-Mullerian hormone for live birth after assisted conception: a systematic review and meta-analysis of the literature. Hum Reprod Update 2014; 20: 560-70.
van Loendersloot L, Repping S, Bossuyt PM, van der Veen F, van Wely M. Prediction models in in vitro fertilization; where are we? A mini review. J Adv Res 2014; 5: 295-301.
Lehmann P, Vélez MP, Saumet J, et al. Anti-Müllerian hormone (AMH): a reliable biomarker of oocyte quality in IVF. J Assist Reprod Genet 2014; 31: 493-8.
Brodin T, Hadziosmanovic N, Berglund L, Olovsson M, Holte J. Antimullerian hormone levels are strongly associated with live-birth rates after assisted reproduction. J Clin Endocrinol Metab 2013; 98: 1107-14.
Mao GH, Feng Z, He Y, Huang YR. Comparisons of the effects of long-acting and short-acting GnRH agonists on embryo quality, endometrial thickness and pregnancy rate in human in vitro fertilization. Arch Med Sci 2014; 10: 161-6.
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