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Ovarian response is defined as the quantitative and qualitative endocrine and follicular reaction of the ovaries to a stimulus while ovarian reserve refers to the quantitation of residual pool of primordial follicles in the ovary and represents the reproductive age of the women (Kamini Rao et al., 2013).
During an Assisted Reproductive Technology (ART) cycle, ovarian responsiveness to gonadotropins is crucial for a successful clinical outcome. The quantity of embryos available for transfer and freezing is ultimately related to the number of follicles that develop during ART stimulation (Arnot et al., 1995).
The evaluation of ovarian reserve has been and still substantial clinical research (Buckman et al., 2001).
The assessment of ovarian reserve is valuable for determining stimulation protocols and predicting ART outcome. The concept of diminished ovarian reserve has gained general acceptance in infertility medicine. Correct identification of patients who are at risk for poor response can help physicians to individualize counseling and permit the patients to decide whether to undergo a demanding infertility treatment. Accurate assessment of ovarian response potential before the patient enters an IVF program is, therefore, of pivotal importance (Jenkins et al., 1991).
The limited predictive value of age alone in estimating fecundity rates and response to the exogenous stimulation lead to evaluation of other parameters (Faddy and Gosden, 1996).
The aim of this study was to evaluate the accuracy Inhibin B hormone as a predictor of poor ovarian responder patients scheduled for ICSI.
This prospective study included 77 patients undergoing ICSI treatment in the assisted reproductive unit in Ain Shams Maternity Hospital. All women included in the study aged between 20-40 years With mean duration of infertility of 6 years. The study elicited the basal hormonal profile, AFC, number of HMG ampoules and number of oocytes retrieved of the whole studied cases. Patients included in the study were divided retrospectively into two groups according to the number of retrieved oocytes: normal responders with four or more retrieved oocytes and poor responders with less than four retrieved oocytes.
All women included in the study, starting long protocol treatment for ICSI were randomly selected. Certain exclusion criteria were respected in these patients
PCOs, patients receiving hormonal therapy within 3 months of the hormonal assay and azospermic males in need of testicular biopsy.
Venous blood samples were drawn from each patient on day 3 of non-treated cycle within 3 months before ovarian stimulation for ICSI to measure E2, FSH, Inhibin B & LH. Transvaginal ultrasound was also done for AFC on day 3 of non-treated cycle within 3 months before ovarian stimulation.
The results of this prospective study were tabulated and statistically correlated where it documented that there were statistical significant differences between poor responders and normal responders as regard Inhibin B serum level. Inhibin B serum levels were significantly lower in the poor responding women compared to normal responding women while FSH showed a higher level in poor compared to normal responders.