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Abstract
Recruitment and development of multiple ovarian follicles in response to gonadotrophic stimulation are necessary for successful assisted reproductive treatment.
The ability of the ovary to respond to gonadotropins with adequate follicular development has been referred to as ovarian reserve. Although ovarian reserve declines with age it is a biological not a chronological function. In fact the most important aspect in diminished ovarian reserve is that the timing of its onset is highly variable (Scott and Hofmann, 1995). Thus a useful biomarker of ovarian response to controlled ovarian hyperstimulation in assisted reproduction is needed.
Many tests have been developed to screen for diminished ovarian reserve. Traditional methods used to predict prospectively response to ovarian stimulation have included mainly the measurement of baseline cycle day 3 serum concentration of hormones such as FSH, estradiol and inhibins, or ultrasonographic tests such as pretreatment ovarian volume and the number of early antral follicles.
The ability to predict ovarian response early in the course of controlled ovarian hyperstimulation would provide the opportunity of obtaining information to assist in deciding whether to proceed with an ongoing cycle.
Recently Anti-Mullerian hormone (AMH) also referred to as Mullerian inhibiting substance, has been proposed as a novel marker for predicting ovarian response to gonadotropin stimulation.