Background: Abnormal ovarian reserve test (ORT) results and, woman age are strong predictors of cycle cancellation during assisted reproductive technique. Use of Anti- Mullerian hormonecan helps to decide cycle cancellation during ICSI at different age groups.
Objectives: To evaluate the role of biomarkers (Anti-Mullerian, FSH hormones) and antral follicle count, as predictors of cycle cancellation in women during antagonistic protocol ICSI.
Participants and Methods: Retrospective study of 491 cases received ovarian stimulation for ICSI by antagonist protocol during the period of 2013-2014, at Misurata National Infertility management center was conducted. Candidate characteristics were collected, endocrine data, collected during early follicular phase (D3) of the stimulating cycle (FSH, AMH). Sonographic data were collected during early follicular phase by counting antral follicles in both ovaries, and after stimulation. An antagonist protocol was applied to all patients of different age groups.
Results: Cycle cancellation occurred in 24.64% of stimulated patients. The mean age for the patients with cancelled cycles was higher than the age of those with completed cycles, and 16.7% got pregnant. The age of the women who got pregnant was lower than the age of non-pregnant women . AMH was a fair test for the discrimination between cancelled and completed cycles with a highly significant value . When investigating the three age groups, AMH was a fair test for the discrimination between cancelled and completed cycles for age group >39 years.
Conclusion: Serum AMH levels can be used as a fair predictor test for cycle cancellation especially in older age group patients. Its use can help to individualize treatments protocols and counselling in different age groups. Counselling plays an important role in addressing psychological issues discussing the risks of cycle cancellation due to costbenefit, and treatment options to ensure maximal therapy benefits and outcomes.
Correspondence: Bouthinagreiw@gmail. Research Center, National infertility center, Assisted Reproductive Technique Unit,Misurata Libya.