Anti Mullerian Hormone: Ovarian Response Indicator in Young Patients Receiving Long GnRH Agonist Protocol for Stimulation

Anti Mullerian hormone (AMH) is gaining recognition as a reliable biomarker for assessing ovarian response to gonadotropin stimulation in Assisted Reproductive Technology. This study evaluated its correlation with oocyte retrieval following a long GnRH agonist protocol in both younger and older infertile populations. We conducted a retrospective analysis of 166 infertile females undergoing IVF with ICSI treatment from June 2014 to March 2015. Serum samples collected on day 3 were analyzed for Follicle Stimulating hormone (FSH), Luteinizing hormone, Estradiol, and AMH levels. Antral follicle count was measured using transvaginal ultrasound. Outcomes were categorized as good responders (5 to 19 oocytes) and poor responders (fewer than 5 oocytes). ROC analysis demonstrated AMH's superior discriminatory power (AUROC; 0.771; p < 0.05) compared to FSH (AUROC; 0.692; p < 0.05) and AFC (AUROC; 0.690; p < 0.01). AMH showed a stronger association with outcomes than FSH and AFC, with odds ratios of 15.06, 4.12, and 0.81, respectively. Subgroup analysis revealed a 68.6% risk of poor response in patients with AMH levels below 1.37 ng/ml, a significant finding in patients under 35 years of age (r=0.245; p=0.012) but not in older patients (r=0.169; p>0.05). The study confirms that serum AMH is a reliable predictor of oocyte retrieval, particularly in younger infertile women, and recommends AMH evaluation as a baseline assessment for those advised to delay interventions based on age and normal FSH levels.