Anti-mullerian Hormone Serum Level as a Predictor of Responsiveness to Clomiphene Citrate Therapy in Iraqi Women with PCOS

Dhai Rashid; Raghda Bardan

doi:10.3889/oamjms.2022.8691

Authors

Dhai Rashid Department of Obstetrics and Gynecology, College of Medicine, Al-Anbar University, Ramadi, Iraq https://orcid.org/0000-0003-3935-6840
Raghda Bardan Department of Obstetrics and Gynecology, College of Medicine, Al-Anbar University, Ramadi, Iraq https://orcid.org/0000-0003-4222-0610

DOI:

https://doi.org/10.3889/oamjms.2022.8691

Keywords:

Anti-Müllerian hormone, Clomiphene citrate, Ovulation prediction, Polycystic ovarian syndrome

Abstract

BACKGROUND: Ovulation induction in polycystic ovarian syndrome is one of the most common interventions used in the treatment of infertility and prediction of the response is very important. Although the serum anti-mullerian hormone (AMH) concentrations are known to be a reliable predictor of ovarian response in in vitro fertilization, in women with polycystic ovary syndrome (PCOS) with a higher level of AMH ovulation induction by clomiphene citrate may be not enough to increase the level of follicle-stimulating hormone and reduce the intraovarain AMH to a level that compatible with the restoration of ovulation.

AIM: Our study aimed to identify those females who will respond to treatment and the starting dose of anti-mullerian hormone serum level as a predictor of responsiveness to clomiphene citrate therapy in Iraqi women with PCOS.

METHODS: 79 females with polycystic ovarian syndrome were included in the study. AMH serum concentrations were determined on the second or 3^rdday of the early follicular phase of the menstrual cycle before initiating clomiphene citrate in the first treatment cycle.

RESULTS: The females were falling-out into two groups according to their response to treatment. The patient who ovulated had a significantly lower AMH level among responders 7.89 +−3.2 compared to non-responder 9.41 +−3.27. The women who responded at 50 mg dose had lower AMH 6.56 +−2.2 compared to women who responded at 100mg clomiphene citrate had AMH of 8.74 +−3 with optimum cutoff value for AMH is 6.25 to respond.

CONCLUSION: Serum AMH level measurement prior to treatment initiation in women with PCOS may be a useful method for predicting the outcome of clomiphene citrate treatment, and for each specific ethnic group, there is a cutoff value for AMH above which the response to clomiphene citrate is impaired.

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