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320852

Inhibin A may be the Black Horse for Determination of the Optimal Triggering Time and Decision-making for Oocyte Retrieval

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Last updated: 23 Dec 2024

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Abstract

Objectives: Assessment of the applicability of estimated serum inhibin A (INHA) and/or INHB versus estradiol (E2) levels to determine the triggering time during controlled ovarian stimulation (COS) that might allow the retrieval of the optimal number of oocytes.   Patients: 196 infertile women assigned to receive COS using the flexible antagonist protocol gave blood samples for ELISA estimation of serum levels of E2 and INHs on day-2 of the cycle and on the day of retrieval depending on having serum E2 levels >2000 pg/ml and the optimal number of follicles; 11-15 follicles of ≥16 mm in diameter.  The study outcome is the blinded distinguishing ability of estimated serum levels of E2 and INHs between cases that might have <11, 11-13, and 14-15 mature follicles on transvaginal ultrasonography (TUV) imaging on the day of triggering.    Results: Serum E2 levels at the time of triggering (>2000 pg/ml) showed sensitivity and specificity rates of 89.8% and 40.6% to distinguish women who had <11 mature follicles after COS. Serum levels of INHA (≥723 ng/ml) showed significantly higher diagnostic performance for differentiation between patients according to the number of mature follicles compared to serum E2 and INHB levels with significant area under the curve (AUC) for differentiating patients had <11 or >14 mature follicles, while E2 and INHB failed for this respect. Statistical analyses defined serum INHA as the significant predictor for canceling depending on the maturation of a low number of follicles after COS and for the presence of 14-15 mature follicles and deciding triggering and oocyte retrieval.    Conclusion:  Estimation of serum E2 is an unreliable marker for differentiating women according to several mature follicles. Estimated serum levels of INHA are the best biomarker for the identification of women who might have <11 follicles and women who might have ≥14 mature follicles with high specificity.

DOI

10.21608/egyfs.2023.320852

Keywords

Keywords: Triggering time, the optimal number of mature follicles, Inhibins, estradiol, Decision Making

Authors

First Name

yousef

Last Name

Abdel Zaher

MiddleName

-

Affiliation

Department of Obstetrics & Gynecology, Faculty of Medicine, Benha University

Email

yousef.yousef.yousef.abdelzaher@fmed.bu.edu.eg

City

-

Orcid

-

First Name

Omnia

Last Name

Habashy

MiddleName

Youssef

Affiliation

Department of Medical Biochemistry & Molecular Biology, Faculty of Medicine, Benha University

Email

-

City

-

Orcid

-

First Name

Hamasat

Last Name

Alnoury

MiddleName

A

Affiliation

Department of Clinical and Chemical Pathology, Faculty of Medicine, Benha University

Email

-

City

-

Orcid

-

First Name

Wagdy

Last Name

Amer

MiddleName

Megahed

Affiliation

-

Email

-

City

-

Orcid

-

Volume

27

Article Issue

5

Related Issue

43878

Issue Date

2023-09-01

Receive Date

2023-10-10

Publish Date

2023-09-01

Page Start

98

Page End

107

Print ISSN

1110-6352

Online ISSN

2536-9768

Link

https://egyfs.journals.ekb.eg/article_320852.html

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https://egyfs.journals.ekb.eg/service?article_code=320852

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13

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Original Article

Type Code

319

Publication Type

Journal

Publication Title

The Egyptian Journal of Fertility of Sterility

Publication Link

https://egyfs.journals.ekb.eg/

MainTitle

Inhibin A may be the Black Horse for Determination of the Optimal Triggering Time and Decision-making for Oocyte Retrieval

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Article

Created At

23 Dec 2024