Effects of anti-müllerian hormone and inhibin B on the outcome of in vitro fertilization-embryo transfer

Objective:To research the relationship between anti-mullerian hormone(AMH) and inhibin B in serum and follicular fluid and the development of follicles,ovarian reaction ability,quality of embryos,and pregnancy outcome of the patients receiving in vitro fertilization-embryo transfer(IVF-ET).Methods:Enzyme-linked immunosorbent assay(ELISA) was used to detect the levels of AMH and inhibin B in serum during the early follicular phase(on the third day of menstruation),middle follicular phase,on the day of oocyte pick-up(OPU),on the day of embryo transfer,on the third day after embryo transfer and the levels of AMH and inhibin B in follicular fluid on the day of OPU;the relationship between the levels of AMH and inhibin B and follicular development,ovarian reaction ability,quality of embryo,and pregnancy outcome was analyzed.Results:The serum level of inhibin B increased gradually with the development of follicles,while the level of serum AMH decreased gradually(P0.001,P0.001,respectively).The levels of AMH and inhibin B in follicular fluid on the day of OPU were significantly higher than those in serum(P0.001,P0.05,respectively).During the course of controlled ovarian hyperstimulation(COH),the serum levels of inhibin B at different phases increased significantly with the increase of the number of retrieved oocytes(P0.05),the levels of AMH in follicular fluid varied with the number of retrieved oocytes,the level of AMH in follicular fluid was the lowest when the number of retrieved oocytes was 0-9,while the level of AMH in follicular fluid was the highest when the number of retrieved oocytes was 10-15,the level of AMH in follicular fluid decreased significantly when the number of retrieved oocytes was more than 16(including 16)(P0.05).The level of AMH in follicular fluid in ratio of high quality embryo≥0.5 group was significantly higher than that in ratio of high quality embryo0.5 group(P0.05).There was no significant difference in the levels of AMH and inhibin B in serum during the early follicular phase,middle follicular phase,on the day of OPU,on the day of embryo transfer,on the third day after embryo transfer and the level of inhibin B in follicular fluid on the day of OPU between pregnancy group and non-pregnancy group(P0.05),the level of AMH in follicular fluid in pregnancy group was significantly higher than that in non-pregnancy group(P0.05).Conclusion:The serum levels of inhibin B at different phases of COH only can reflect ovarian reaction ability,and they can't predict the pregnancy outcome of IVF-ET;there is no correlation between the level of inhibin B in follicular fluid on the day of OPU and pregnancy outcome.The serum levels of AMH at different phases of COH can't predict the pregnancy outcome of IVF-ET,the level of AMH in follicular fluid on the day of OPU can be used as a predictive factor of pregnancy outcome of IVF-ET.AMH in follicular fluid can induce the change of embryonic quality by changing the focal microenvironment,then it can affect the outcome of IVF-ET.